Manual drive functions for surgical tool having carriage architecture

ABSTRACT

A method of manually operating a surgical tool includes arranging the surgical tool adjacent a patient, the surgical tool including a drive housing having opposing first and second ends, a spline extending between the first and second ends and being rotatably coupled to a drive input at the first end, a drive gear coupled to and rotatable with the spline, a carriage movably mounted to the spline and housing an activating mechanism operatively coupled to the drive gear such that rotation of the spline actuates the activating mechanism, and a bailout mechanism arranged at the second end and including a lever engageable with the spline. The lever is movable relative to the spline to engage the lever allow the lever to be manually rotated to rotate the spline and the drive gear to manually actuate the activating mechanism.

TECHNICAL FIELD

The systems and methods disclosed herein are directed to surgical toolsand, more particularly, to mechanisms for manually actuating or drivingvarious functions of a robotic surgical tool.

BACKGROUND

Minimally invasive surgical (MIS) instruments are often preferred overtraditional open surgical devices due to the reduced post-operativerecovery time and minimal scarring. The most common MIS procedure may beendoscopy, and the most common form of endoscopy is laparoscopy, inwhich one or more small incisions are formed in the abdomen of a patientand a trocar is inserted through the incision to form a pathway thatprovides access to the abdominal cavity. The trocar is used to introducevarious instruments and tools into the abdominal cavity, as well as toprovide insufflation to elevate the abdominal wall above the organs. Theinstruments can be used to engage and/or treat tissue in a number ofways to achieve a diagnostic or therapeutic effect.

Each surgical tool typically includes an end effector arranged at itsdistal end. Example end effectors include clamps, graspers, scissors,staplers, and needle holders, and are similar to those used inconventional (open) surgery except that the end effector of each tool isseparated from its handle by an approximately 12-inch long shaft. Acamera or image capture device, such as an endoscope, is also commonlyintroduced into the abdominal cavity to enable the surgeon to view thesurgical field and the operation of the end effectors during operation.The surgeon is able to view the procedure in real-time by means of avisual display in communication with the image capture device.

Various robotic systems have recently been developed to assist in MISprocedures. Robotic systems can allow for more intuitive hand movementsby maintaining natural eye-hand axis. Robotic systems can also allow formore degrees of freedom in movement by including a “wrist” joint thatcreates a more natural hand-like articulation. The instrument's endeffector can be articulated (moved) using motors and actuators formingpart of a computerized motion system. A user (e.g., a surgeon) is ableto remotely operate an instrument's end effector by grasping andmanipulating in space one or more controllers that communicate with aninstrument driver coupled to the surgical instrument. User inputs areprocessed by a computer system incorporated into the robotic surgicalsystem and the instrument driver responds by actuating the motors andactuators of the motion system. Moving the drive cables articulates theend effector to desired positions and configurations.

Improvements to robotically-enabled medical systems will providephysicians with the ability to perform endoscopic and laparoscopicprocedures more effectively and with improved ease.

SUMMARY OF DISCLOSURE

Various details of the present disclosure are hereinafter summarized toprovide a basic understanding. This summary is not an extensive overviewof the disclosure and is neither intended to identify certain elementsof the disclosure, nor to delineate the scope thereof. Rather, theprimary purpose of this summary is to present some concepts of thedisclosure in a simplified form prior to the more detailed descriptionthat is presented hereinafter.

Embodiments disclosed herein include a surgical tool that includes adrive housing having a first end and a second end, a spline extendingbetween the first and second ends and being rotatably coupled to thefirst end at a drive input, a drive gear coupled to and rotatable withthe spline, a carriage movably mounted to the spline and housing anactivating mechanism operatively coupled to the drive gear such thatrotation of the spline actuates the activating mechanism, and a bailoutmechanism arranged at the second end and including a lever, the leverbeing movable relative to the spline from a first position, where thespline is disengaged from the lever, to a second position, where thespline engages the lever such that rotation of the lever correspondinglyrotates the spline. In some embodiments, the surgical tool furtherincludes an instrument driver arranged at an end of a robotic arm andmatable with the first end of the drive housing, and a drive outputprovided by the instrument driver and matable with the drive input suchthat rotation of the drive output correspondingly rotates the driveinput and thereby actuates the activating mechanism, wherein the splineis engaged with the drive output when the lever is in the firstposition, and disengaged from the drive output by movement of the leverinto the second position. In some embodiments, the surgical tool furtherincludes an instrument driver arranged at an end of a robotic arm andmatable with the first end of the drive housing, and a drive outputprovided by the instrument driver and matable with the drive input suchthat rotation of the drive output correspondingly rotates the driveinput and thereby actuates the activating mechanism, wherein the splineremains engaged with the drive output as the lever moves between thefirst position and the second position. In some embodiments, thesurgical tool further includes a manual drive gear provided at aproximal end of the spline and rotatable with the spline, wherein themanual drive gear is rotatable relative to the lever when the lever isin the first position, and wherein the manual drive gear rotationallyengages the lever when the lever is moved to the second position. Insome embodiments, the lever includes at least one gear tooth thatengages a corresponding at least one gear tooth of the manual drive gearwhen the lever is moved into the second position. In some embodiments,the bailout mechanism further includes a spacer bar removably positionedunder the manual drive gear when the lever is in the first position, thelever being movable into the second position upon removal of the spacerbar to thereby position the lever in rotational engagement with themanual drive gear. In some embodiments, the bailout mechanism furtherincludes a removable cover and the spacer bar is attached to theremovable cover, wherein the removable cover is mountable at the secondend of the drive housing to enclose the lever with the spacer barextending under the manual drive gear. In some embodiments, the leverincludes a first bore section and a second bore section, the manualdrive gear being freely rotatable relative to the lever when oriented inthe first bore section of the lever, and the manual drive gear beingrotatable with the lever when oriented in the second bore section of thelever. In some embodiments, the bailout mechanism further includes abiasing element that applies a biasing force on the lever to therebyurge the lever towards the second position. In some embodiments, thebailout mechanism further includes a removable cover mountable at thesecond end of the drive housing and having a retaining pin attached tothe removable cover such that, when the removable cover is mounted onthe drive housing, the retaining pin contacts and maintains the lever inthe first position with the manual drive gear oriented in the first boresection of the lever. In some embodiments, as the retaining pin movesaway from the lever, the biasing element pushes the lever in a directiontowards the second position to thereby orient the manual drive gearwithin the second bore section where the manual drive gear is rotatablewith the lever. In some embodiments, the lever further comprises a ledgepositioned proximate the second bore section to contact the manual drivegear when oriented within the second bore section, such that, as thebiasing element translates the lever in the direction towards the secondposition with the manual drive gear oriented within the second boresection of the lever, the ledge contacts the manual drive gear to carrythe manual drive gear and, thereby, to pull the spline connected to themanual drive gear, in the direction towards the second position. In someembodiments, the surgical tool further includes an elongate shaftextending distally from the carriage and penetrating the first end, anend effector arranged at a distal end of the elongate shaft, a firingrod operatively coupled to the activating mechanism to translate uponrotation of the drive gear, the firing rod extending through theelongate shaft, and a cutting element provided at the end effector andoperatively coupled to a distal end of the firing rod, wherein actuatingthe activating mechanism advances or retracts the cutting element, andwherein the activating mechanism includes an internally threaded geararranged around a threaded portion of the firing rod, the internallythreaded gear being meshed with the drive gear on the spline such thatrotation of the spline causes axial translation of the firing rod, andthe drive gear is axially longer than the internally threaded gear suchthat the drive gear remains meshed with the internally threaded gearwhen the spline is in the first and second positions. In someembodiments, the surgical tool further includes an elongate shaftextending distally from the carriage and penetrating the first end, anend effector arranged at a distal end of the elongate shaft, a firingrod operatively coupled to the activating mechanism to translate uponrotation of the drive gear, the firing rod extending through theelongate shaft, and a cutting element provided at the end effector andoperatively coupled to a distal end of the firing rod, wherein actuatingthe activating mechanism advances or retracts the cutting element. Insome embodiments, the spline comprises a first spline, the drive gearcomprises a first drive gear and the activating mechanism comprises afirst activating mechanism, and the surgical tool further comprises: asecond spline extending from the first end, a second drive gear coupledto the second spline and rotatable with rotation of the second spline,and a second activating mechanism housed in the carriage and operativelycoupled to the second drive gear to open or close the jaws uponactivation of the second activating mechanism, wherein the firstactivating mechanism includes an internally threaded gear arrangedaround a threaded portion of the firing rod, the internally threadedgear being meshed with the first drive gear on the first spline suchthat rotation of the first spline causes axial translation of the firingrod.

Embodiments disclosed herein include a surgical tool that includes adrive housing having a first end and a second end, a spline extendingbetween the first and second ends and being rotatably coupled to thefirst end at a drive input, a drive gear mounted on and rotatable withthe spline, a manual drive gear mounted on a proximal end of the splineand rotatable with the spline, a carriage movably mountable to thespline and housing an activating mechanism operatively coupled to thedrive gear such that rotation of the spline actuates the activatingmechanism, a lever coupled to the proximal end of the spline, and aremovable cover provided on the second end of the drive housing toenclose the lever and having a spacer bar that is positioned beneath thelever to support the lever in a first position, where the manual drivegear is disengaged from the lever and freely rotatable relative to thelever, wherein, upon removal of the spacer bar from beneath the lever,the lever is movable to a second position, where the lever engages themanual driver gear such that rotation of the lever correspondinglyrotates the spline. In some embodiments, the lever includes a borehaving a distal portion and a proximal portion, the lever being movableto orient the manual drive gear between the distal portion of the bore,where the manual drive gear is uncoupled from and freely rotatableindependent of the lever, and the proximal portion of the bore, wherethe manual drive gear is coupled to the lever such that rotation of thelever correspondingly rotates the spline. In some embodiments, the boreand the manual drive gear each include a corresponding keyed surfacethat are engageable with each other to couple the manual drive gear tothe lever when the lever is moved, relative to the manual drive gear andin a direction towards first end, to thereby orient the manual drivegear within the proximal portion of the bore.

Embodiments disclosed herein include a surgical tool that includes adrive housing having a first end and a second end, a spline extendingbetween the first and second ends and being rotatably coupled to thefirst end at a drive input, a drive gear coupled to and rotatable withthe spline, a manual drive gear provided on a proximal end of the splineand rotatable with the spline, a carriage movably mountable to thespline and housing an activating mechanism operatively coupled to thedrive gear such that rotation of the spline actuates the activatingmechanism, an end cap provided at the second end with the splineextending through the cap, a lever provided on the proximal end of thespline and having a bore within which the manual drive gear is provided,the bore comprising a first bore section, within which the manual drivegear is freely rotatable relative to the lever when oriented therein,and a second bore section, within which the manual drive gear isrotatable with the lever when oriented therein, wherein the lever ismovable relative to the manual drive gear between a first position,where the manual drive gear is oriented in first bore section and thusdisengaged from and rotatable relative to the lever, and a secondposition, where the manual drive gear is oriented in second bore sectionand thus engaged and rotatable with lever, a biasing element arranged tourge the lever towards the second position, and a removable covermountable on the end cap to enclose the lever and having a retaining pinpositioned within an interior of the removable cover such that, when theremovable cover is mounted on the end cap, the retaining pin contactsthe lever to thereby maintain the lever in the first position with themanual drive gear oriented in the first bore section of the lever,wherein, as the removable cover is removed causing the retaining pin tomove away from the lever, the biasing element pushes the lever in adirection towards the second position to thereby orient the manual drivegear within the second bore section where the manual drive gear isrotatable with the lever. In some embodiments, the lever furthercomprises a ledge positioned proximate the second bore section tocontact the manual drive gear when oriented within the second boresection, such that, as the biasing element translates the lever in thedirection towards the second position with the manual drive gearoriented within the second bore section of the lever, the ledge contactsthe manual drive gear to carry the manual drive gear and, thereby, topull the spline connected to the manual drive gear, in the directiontowards the second position.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosed aspects will hereinafter be described in conjunction withthe appended drawings, provided to illustrate and not to limit thedisclosed aspects, wherein like designations denote like elements.

FIG. 1 illustrates an embodiment of a cart-based robotic system arrangedfor diagnostic and/or therapeutic bronchoscopy procedure(s).

FIG. 2 depicts further aspects of the robotic system of FIG. 1 .

FIG. 3A illustrates an embodiment of the robotic system of FIG. 1arranged for ureteroscopy.

FIG. 3B illustrates an embodiment of the robotic system of FIG. 1arranged for a vascular procedure.

FIG. 4 illustrates an embodiment of a table-based robotic systemarranged for a bronchoscopy procedure.

FIG. 5 provides an alternative view of the robotic system of FIG. 4 .

FIG. 6 illustrates an example system configured to stow robotic arm(s).

FIG. 7A illustrates an embodiment of a table-based robotic systemconfigured for a ureteroscopy procedure.

FIG. 7B illustrates an embodiment of a table-based robotic systemconfigured for a laparoscopic procedure.

FIG. 7C illustrates an embodiment of the table-based robotic system ofFIGS. 4-7B with pitch or tilt adjustment.

FIG. 8 provides a detailed illustration of the interface between thetable and the column of the table-based robotic system of FIGS. 4-7 .

FIG. 9A illustrates an alternative embodiment of a table-based roboticsystem.

FIG. 9B illustrates an end view of the table-based robotic system ofFIG. 9A.

FIG. 9C illustrates an end view of a table-based robotic system withrobotic arms attached thereto.

FIG. 10 illustrates an exemplary instrument driver.

FIG. 11 illustrates an exemplary medical instrument with a pairedinstrument driver.

FIG. 12 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument.

FIG. 13 illustrates an instrument having an instrument-based insertionarchitecture.

FIG. 14 illustrates an exemplary controller.

FIG. 15 depicts a block diagram illustrating a localization system thatestimates a location of one or more elements of the robotic systems ofFIGS. 1-7C, such as the location of the instrument of FIGS. 11-13 , inaccordance to an example embodiment.

FIG. 16 is an isometric side view of an example surgical tool that mayincorporate some or all of the principles of the present disclosure.

FIG. 17 is an isometric view of the surgical tool of FIG. 16 whenunassembled from its shroud assembly, according to one or moreembodiments.

FIG. 18A is an isometric view of the surgical tool of FIGS. 16-17releasably coupled to an example instrument driver, according to one ormore embodiments.

FIG. 18B provides separated isometric end views of the instrument driverof FIG. 18A and the surgical tool of FIGS. 16-17 .

FIG. 19 illustrates the surgical tool of FIGS. 16-17 having a stageportion and an instrument portion when removed from a stage portion,according to one or more embodiments.

FIGS. 20A-20B illustrate respective bottom end and top end views of theremovable cap of FIG. 19 , according to one or more embodiments.

FIG. 21 illustrates a partially-exploded view of the removable cap ofFIGS. 20A-20B, according to one or more embodiments.

FIG. 22 illustrates a partially disassembled view of the removable capwhen installed on the surgical tool and in operational engagement withthe lead screw and the splines, according to one or more embodiments.

FIG. 23 illustrates a partially disassembled view of a distal manualactuation mechanism for manually activating one or more functions of asurgical tool, according to one or more embodiments.

FIG. 24 illustrates a manual lever jaw opening and closure mechanism,according to one or more embodiments.

FIGS. 25A-25C illustrate an exemplary operation of the mechanism of FIG.24 .

FIG. 26A illustrates a clutching mechanism, according to one or moreembodiments.

FIG. 26B illustrates an exploded view of the clutching mechanism of FIG.26A.

FIG. 26C illustrates a partially disassembled view of the clutchingmechanism of FIG. 26A, wherein the clutch has been removed to illustratea pinion gear of the spline driver relative to a pinion gear boss of thedrive input.

FIG. 26D illustrates a cross-sectional view of the clutching mechanismof FIG. 26A.

FIGS. 27A-27D illustrate example operation of the clutching mechanism ofFIGS. 26A-D, according to one or more embodiments

FIG. 28 illustrates a multi-clutching assembly utilizable to disengagetwo or more of the clutching mechanisms of FIG. 26A, according to one ormore embodiments of the present disclosure.

FIG. 29 illustrates the clutching mechanism of FIG. 26A incorporating amanual override feature, according to one or more embodiments.

FIG. 30 illustrates a bailout mechanism, according to one or moreembodiments.

FIG. 31 illustrates example operation of the bailout mechanism,according to one or more alternate embodiments of the presentdisclosure.

FIG. 32 illustrates the bailout mechanism incorporating a bailout assistmechanism 3200, according to one or more embodiments of the presentdisclosure.

illustrates the bailout assist mechanism

FIGS. 33A-33B illustrate example operation of the bailout assistmechanism of FIG. 32 , according to one or more embodiments of thepresent disclosure

FIGS. 34A-34B illustrate a bailout mechanism for a backdrivable motor,according to one or more other embodiments of the present disclosure.

FIGS. 35A-35B illustrate a bailout mechanism for a non-backdrivablemotor, according to one or more other embodiments of the presentdisclosure.

FIG. 36 illustrates user interface mechanism, according to one or moreother embodiments of the present disclosure.

FIG. 37 illustrates example operation of the user interface mechanism ofFIG. 36 .

FIG. 38 illustrates a detailed cross-section of user interface mechanismof FIG. 36 when in a locked position.

DETAILED DESCRIPTION 1. Overview

Aspects of the present disclosure may be integrated into arobotically-enabled medical system capable of performing a variety ofmedical procedures, including both minimally invasive (e.g.,laparoscopy) and non-invasive (e.g., endoscopy) procedures. Amongendoscopy procedures, the system may be capable of performingbronchoscopy, ureteroscopy, gastroscopy, etc.

In addition to performing the breadth of procedures, the system mayprovide additional benefits, such as enhanced imaging and guidance toassist the physician. Additionally, the system may provide the physicianwith the ability to perform the procedure from an ergonomic positionwithout the need for awkward arm motions and positions. Still further,the system may provide the physician with the ability to perform theprocedure with improved ease of use such that one or more of theinstruments of the system can be controlled by a single user.

Various embodiments will be described below in conjunction with thedrawings for purposes of illustration. It should be appreciated thatmany other implementations of the disclosed concepts are possible, andvarious advantages can be achieved with the disclosed implementations.Headings are included herein for reference and to aid in locatingvarious sections. These headings are not intended to limit the scope ofthe concepts described with respect thereto. Such concepts may haveapplicability throughout the entire specification.

A. Robotic System—Cart.

The robotically-enabled medical system may be configured in a variety ofways depending on the particular procedure. FIG. 1 illustrates anembodiment of a cart-based robotically-enabled system 100 arranged for adiagnostic and/or therapeutic bronchoscopy procedure. For a bronchoscopyprocedure, the robotic system 100 may include a cart 102 having one ormore robotic arms 104 (three shown) to deliver a medical instrument(alternately referred to as a “surgical tool”), such as a steerableendoscope 106 (e.g., a procedure-specific bronchoscope forbronchoscopy), to a natural orifice access point (i.e., the mouth of thepatient) to deliver diagnostic and/or therapeutic tools. As shown, thecart 102 may be positioned proximate to the patient's upper torso inorder to provide access to the access point. Similarly, the robotic arms104 may be actuated to position the bronchoscope relative to the accesspoint. The arrangement in FIG. 1 may also be utilized when performing agastro-intestinal (GI) procedure with a gastroscope, a specializedendoscope for GI procedures.

Once the cart 102 is properly positioned adjacent the patient, therobotic arms 104 are operated to insert the steerable endoscope 106 intothe patient robotically, manually, or a combination thereof. Thesteerable endoscope 106 may comprise at least two telescoping parts,such as an inner leader portion and an outer sheath portion, where eachportion is coupled to a separate instrument driver of a set ofinstrument drivers 108 (alternately referred to as “tool drivers”). Asillustrated, each instrument driver 108 is coupled to the distal end ofa corresponding one of the robotic arms 104. This linear arrangement ofthe instrument drivers 108, which facilitates coaxially aligning theleader portion with the sheath portion, creates a “virtual rail” 110that may be repositioned in space by manipulating the robotic arms 104into different angles and/or positions. Translation of the instrumentdrivers 108 along the virtual rail 110 telescopes the inner leaderportion relative to the outer sheath portion, thus effectively advancingor retracting the endoscope 106 relative to the patient.

As illustrated, the virtual rail 110 (and other virtual rails describedherein) is depicted in the drawings using dashed lines, thus notconstituting any physical structure of the system 100. The angle of thevirtual rail 110 may be adjusted, translated, and pivoted based onclinical application or physician preference. For example, inbronchoscopy, the angle and position of the virtual rail 110 as shownrepresents a compromise between providing physician access to theendoscope 106 while minimizing friction that results from bending theendoscope 106 into the patient's mouth.

After insertion into the patient's mouth, the endoscope 106 may bedirected down the patient's trachea and lungs using precise commandsfrom the robotic system 100 until reaching a target destination oroperative site. In order to enhance navigation through the patient'slung network and/or reach the desired target, the endoscope 106 may bemanipulated to telescopically extend the inner leader portion from theouter sheath portion to obtain enhanced articulation and greater bendradius. The use of separate instrument drivers 108 also allows theleader portion and sheath portion to be driven independent of eachother.

For example, the endoscope 106 may be directed to deliver a biopsyneedle to a target, such as, for example, a lesion or nodule within thelungs of a patient. The needle may be deployed down a working channelthat runs the length of the endoscope 106 to obtain a tissue sample tobe analyzed by a pathologist. Depending on the pathology results,additional tools may be deployed down the working channel of theendoscope for additional biopsies. After identifying a tissue sample tobe malignant, the endoscope 106 may endoscopically deliver tools toresect the potentially cancerous tissue. In some instances, diagnosticand therapeutic treatments can be delivered in separate procedures. Inthose circumstances, the endoscope 106 may also be used to deliver afiducial marker to “mark” the location of a target nodule as well. Inother instances, diagnostic and therapeutic treatments may be deliveredduring the same procedure.

The system 100 may also include a movable tower 112, which may beconnected via support cables to the cart 102 to provide support forcontrols, electronics, fluidics, optics, sensors, and/or power to thecart 102. Placing such functionality in the tower 112 allows for asmaller form factor cart 102 that may be more easily adjusted and/orre-positioned by an operating physician and his/her staff. Additionally,the division of functionality between the cart/table and the supporttower 112 reduces operating room clutter and facilitates improvingclinical workflow. While the cart 102 may be positioned close to thepatient, the tower 112 may alternatively be stowed in a remote locationto stay out of the way during a procedure.

In support of the robotic systems described above, the tower 112 mayinclude component(s) of a computer-based control system that storescomputer program instructions, for example, within a non-transitorycomputer-readable storage medium such as a persistent magnetic storagedrive, solid state drive, etc. The execution of those instructions,whether the execution occurs in the tower 112 or the cart 102, maycontrol the entire system or sub-system(s) thereof. For example, whenexecuted by a processor of the computer system, the instructions maycause the components of the robotics system to actuate the relevantcarriages and arm mounts, actuate the robotics arms, and control themedical instruments. For example, in response to receiving the controlsignal, motors in the joints of the robotic arms 104 may position thearms into a certain posture or angular orientation.

The tower 112 may also include one or more of a pump, flow meter, valvecontrol, and/or fluid access in order to provide controlled irrigationand aspiration capabilities to the system 100 that may be deployedthrough the endoscope 106. These components may also be controlled usingthe computer system of the tower 112. In some embodiments, irrigationand aspiration capabilities may be delivered directly to the endoscope106 through separate cable(s).

The tower 112 may include a voltage and surge protector designed toprovide filtered and protected electrical power to the cart 102, therebyavoiding placement of a power transformer and other auxiliary powercomponents in the cart 102, resulting in a smaller, more moveable cart102.

The tower 112 may also include support equipment for sensors deployedthroughout the robotic system 100. For example, the tower 112 mayinclude opto-electronics equipment for detecting, receiving, andprocessing data received from optical sensors or cameras throughout therobotic system 100. In combination with the control system, suchopto-electronics equipment may be used to generate real-time images fordisplay in any number of consoles deployed throughout the system,including in the tower 112. Similarly, the tower 112 may also include anelectronic subsystem for receiving and processing signals received fromdeployed electromagnetic (EM) sensors. The tower 112 may also be used tohouse and position an EM field generator for detection by EM sensors inor on the medical instrument.

The tower 112 may also include a console 114 in addition to otherconsoles available in the rest of the system, e.g., a console mounted tothe cart 102. The console 114 may include a user interface and a displayscreen (e.g., a touchscreen) for the physician operator. Consoles in thesystem 100 are generally designed to provide both robotic controls aswell as pre-operative and real-time information of the procedure, suchas navigational and localization information of a medical tool. When theconsole 114 is not the only console available to the physician, it maybe used by a second operator, such as a nurse, to monitor the health orvitals of the patient and the operation of system, as well as provideprocedure-specific data, such as navigational and localizationinformation. In other embodiments, the console 114 may be housed in abody separate from the tower 112.

The tower 112 may be coupled to the cart 102 and endoscope 106 throughone or more cables 116 connections. In some embodiments, supportfunctionality from the tower 112 may be provided through a single cable116 extending to the cart 102, thus simplifying and de-cluttering theoperating room. In other embodiments, specific functionality may becoupled in separate cabling and connections. For example, while powermay be provided through a single power cable to the cart 102, supportfor controls, optics, fluidics, and/or navigation may be providedthrough one or more separate cables.

FIG. 2 provides a detailed illustration of an embodiment of the cart 102from the cart-based robotically-enabled system 100 of FIG. 1 . The cart102 generally includes an elongated support structure 202 (also referredto as a “column”), a cart base 204, and a console 206 at the top of thecolumn 202. The column 202 may include one or more carriages, such as acarriage 208 (alternatively “arm support”) for supporting the deploymentof the robotic arms 104. The carriage 208 may include individuallyconfigurable arm mounts that rotate along a perpendicular axis to adjustthe base 214 of the robotic arms 104 for better positioning relative tothe patient. The carriage 208 also includes a carriage interface 210that allows the carriage 208 to vertically translate along the column202.

The carriage interface 210 is connected to the column 202 through slots,such as slot 212, that are positioned on opposite sides of the column202 to guide the vertical translation of the carriage 208. The slot 212contains a vertical translation interface to position and hold thecarriage 208 at various vertical heights relative to the cart base 204.Vertical translation of the carriage 208 allows the cart 102 to adjustthe reach of the robotic arms 104 to meet a variety of table heights,patient sizes, and physician preferences. Similarly, the individuallyconfigurable arm mounts on the carriage 208 allow a base 214 of therobotic arms 104 to be angled in a variety of configurations.

In some embodiments, the slot 212 may be supplemented with slot covers(not shown) that are flush and parallel to the slot surface to preventdirt and fluid ingress into the internal chambers of the column 202 andthe vertical translation interface as the carriage 208 verticallytranslates. The slot covers may be deployed through pairs of springspools positioned near the vertical top and bottom of the slot 212. Thecovers are coiled within the spools until deployed to extend and retractfrom their coiled state as the carriage 208 vertically translates up anddown. The spring-loading of the spools provides force to retract thecover into a spool when carriage 208 translates towards the spool, whilealso maintaining a tight seal when the carriage 208 translates away fromthe spool. The covers may be connected to the carriage 208 using, forexample, brackets in the carriage interface 210 to ensure properextension and retraction of the cover as the carriage 208 translates.

The column 202 may internally comprise mechanisms, such as gears andmotors, that are designed to use a vertically aligned lead screw totranslate the carriage 208 in a mechanized fashion in response tocontrol signals generated in response to user inputs, e.g., inputs fromthe console 206.

The robotic arms 104 may generally comprise robotic arm bases 214 andend effectors 216 (three shown), separated by a series of linkages 218connected by a corresponding series of joints 220, each joint 220including an independent actuator, and each actuator including anindependently controllable motor. Each independently controllable joint220 represents an independent degree of freedom available to thecorresponding robotic arm 104. In the illustrated embodiment, each arm104 has seven joints 220, providing seven degrees of freedom. Amultitude of joints 220 result in a multitude of degrees of freedom,allowing for “redundant” degrees of freedom. Redundant degrees offreedom allow the robotic arms 104 to position its respective endeffectors 216 at a specific position, orientation, and trajectory inspace using different linkage positions and joint angles. This allowsfor the system 100 to position and direct a medical instrument from adesired point in space while allowing the physician to move the armjoints 220 into a clinically advantageous position away from the patientto create greater access, while avoiding arm collisions.

The cart base 204 balances the weight of the column 202, carriage 208,and arms 104 over the floor. Accordingly, the cart base 204 housesheavier components, such as electronics, motors, power supply, as wellas components that either enable movement and/or immobilize the cart.For example, the cart base 204 includes rollable casters 222 that allowfor the cart 102 to easily move around a room prior to a procedure.After reaching an appropriate position, the casters 222 may beimmobilized using locks to hold the cart 102 in place during theprocedure.

Positioned at the vertical end of the column 202, the console 206 allowsfor both a user interface for receiving user input and a display screen(or a dual-purpose device such as, for example, a touchscreen 224) toprovide the physician user with both pre-operative and intra-operativedata. Potential pre-operative data on the touchscreen 224 may includepre-operative plans, navigation and mapping data derived frompre-operative computerized tomography (CT) scans, and/or notes frompre-operative patient interviews. Intra-operative data on thetouchscreen 224 may include optical information provided from the tool,sensor and coordinate information from sensors, as well as vital patientstatistics, such as respiration, heart rate, and/or pulse. The console206 may be positioned and tilted to allow a physician to access theconsole from the side of the column 202 opposite carriage 208. From thisposition, the physician may view the console 206, the robotic arms 104,and the patient while operating the console 206 from behind the cart102. As shown, the console 206 also includes a handle 226 to assist withmaneuvering and stabilizing cart 102.

FIG. 3A illustrates an embodiment of the system 100 of FIG. 1 arrangedfor ureteroscopy. In a ureteroscopic procedure, the cart 102 may bepositioned to deliver a ureteroscope 302, a procedure-specific endoscopedesigned to traverse a patient's urethra and ureter, to the lowerabdominal area of the patient. In ureteroscopy, it may be desirable forthe ureteroscope 302 to be directly aligned with the patient's urethrato reduce friction and forces on the sensitive anatomy. As shown, thecart 102 may be aligned at the foot of the table to allow the roboticarms 104 to position the ureteroscope 302 for direct linear access tothe patient's urethra. From the foot of the table, the robotic arms 104may insert the ureteroscope 302 along a virtual rail 304 directly intothe patient's lower abdomen through the urethra.

After insertion into the urethra, using similar control techniques as inbronchoscopy, the ureteroscope 302 may be navigated into the bladder,ureters, and/or kidneys for diagnostic and/or therapeutic applications.For example, the ureteroscope 302 may be directed into the ureter andkidneys to break up kidney stone build-up using a laser or ultrasoniclithotripsy device deployed down a working channel of the ureteroscope302. After lithotripsy is complete, the resulting stone fragments may beremoved using baskets deployed down the working channel of theureteroscope 302.

FIG. 3B illustrates another embodiment of the system 100 of FIG. 1arranged for a vascular procedure. In a vascular procedure, the system100 may be configured such that the cart 102 may deliver a medicalinstrument 306, such as a steerable catheter, to an access point in thefemoral artery in the patient's leg. The femoral artery presents both alarger diameter for navigation as well as a relatively less circuitousand tortuous path to the patient's heart, which simplifies navigation.As in an ureteroscopic procedure, the cart 102 may be positioned towardsthe patient's legs and lower abdomen to allow the robotic arms 104 toprovide a virtual rail 308 with direct linear access to the femoralartery access point in the patient's thigh/hip region. After insertioninto the artery, the medical instrument 306 may be directed and advancedby translating the instrument drivers 108. Alternatively, the cart 102may be positioned around the patient's upper abdomen in order to reachalternative vascular access points, such as, for example, the carotidand brachial arteries near the patient's shoulder and wrist.

B. Robotic System—Table.

Embodiments of the robotically-enabled medical system may alsoincorporate the patient's table. Incorporation of the table reduces theamount of capital equipment within the operating room by removing thecart, which allows greater access to the patient. FIG. 4 illustrates anembodiment of such a robotically-enabled system 400 arranged for abronchoscopy procedure. As illustrated, the system 400 includes asupport structure or column 402 for supporting platform 404 (shown as a“table” or “bed”) over the floor. Much like in the cart-based systems100, end effectors of the robotic arms 406 of the system 400 compriseinstrument drivers 408 (alternately referred to as “tool drivers”) thatare designed to manipulate an elongated medical instrument, such as abronchoscope 410, through or along a virtual rail 412 formed from thelinear alignment of the instrument drivers 408. In practice, a C-arm forproviding fluoroscopic imaging may be positioned over the patient'supper abdominal area by placing the emitter and detector around thetable 404.

FIG. 5 provides an alternative view of the system 400 without thepatient and medical instrument for discussion purposes. As shown, thecolumn 402 may include one or more carriages 502 shown as ring-shaped inthe system 400, from which the one or more robotic arms 406 may bebased. The carriages 502 may translate along a vertical column interface504 that runs the length (height) of the column 402 to provide differentvantage points from which the robotic arms 406 may be positioned toreach the patient. The carriage(s) 502 may rotate around the column 402using a mechanical motor positioned within the column 402 to allow therobotic arms 406 to have access to multiples sides of the table 404,such as, for example, both sides of the patient. In embodiments withmultiple carriages 502, the carriages 502 may be individually positionedon the column 402 and may translate and/or rotate independent of theother carriages 502. While carriages 502 need not surround the column402 or even be circular, the ring-shape as shown facilitates rotation ofthe carriages 502 around the column 402 while maintaining structuralbalance. Rotation and translation of the carriages 502 allows the system400 to align medical instruments, such as endoscopes and laparoscopes,into different access points on the patient.

In other embodiments (discussed in greater detail below with respect toFIG. 9A), the system 400 can include a patient table or bed withadjustable arm supports in the form of bars or rails extending alongsideit. One or more robotic arms 406 (e.g., via a shoulder with an elbowjoint) can be attached to the adjustable arm supports, which can bevertically adjusted. By providing vertical adjustment, the robotic arms406 are advantageously capable of being stowed compactly beneath thepatient table or bed, and subsequently raised during a procedure.

The arms 406 may be mounted on the carriages 502 through a set of armmounts 506 comprising a series of joints that may individually rotateand/or telescopically extend to provide additional configurability tothe robotic arms 406. Additionally, the arm mounts 506 may be positionedon the carriages 502 such that when the carriages 502 are appropriatelyrotated, the arm mounts 506 may be positioned on either the same side ofthe table 404 (as shown in FIG. 5 ), on opposite sides of table 404 (asshown in FIG. 7B), or on adjacent sides of the table 404 (not shown).

The column 402 structurally provides support for the table 404, and apath for vertical translation of the carriages 502. Internally, thecolumn 402 may be equipped with lead screws for guiding verticaltranslation of the carriages, and motors to mechanize the translation ofsaid carriages based the lead screws. The column 402 may also conveypower and control signals to the carriage 502 and robotic arms 406mounted thereon.

A table base 508 serves a similar function as the cart base 204 of thecart 102 shown in FIG. 2 , housing heavier components to balance thetable/bed 404, the column 402, the carriages 502, and the robotic arms406. The table base 508 may also incorporate rigid casters to providestability during procedures. Deployed from the bottom of the table base508, the casters may extend in opposite directions on both sides of thebase 508 and retract when the system 400 needs to be moved.

In some embodiments, the system 400 may also include a tower (not shown)that divides the functionality of system 400 between table and tower toreduce the form factor and bulk of the table 404. As in earlierdisclosed embodiments, the tower may provide a variety of supportfunctionalities to the table 404, such as processing, computing, andcontrol capabilities, power, fluidics, and/or optical and sensorprocessing. The tower may also be movable to be positioned away from thepatient to improve physician access and de-clutter the operating room.Additionally, placing components in the tower allows for more storagespace in the table base 508 for potential stowage of the robotic arms406. The tower may also include a master controller or console thatprovides both a user interface for user input, such as keyboard and/orpendant, as well as a display screen (or touchscreen) for pre-operativeand intra-operative information, such as real-time imaging, navigation,and tracking information. In some embodiments, the tower may alsocontain holders for gas tanks to be used for insufflation.

In some embodiments, a table base may stow and store the robotic armswhen not in use. FIG. 6 illustrates an embodiment of the system 400 thatis configured to stow robotic arms 606 within a table base 406. In thesystem 400, one or more carriages 602 (one shown) may be verticallytranslated into a base 604 to stow one or more robotic arms 606, one ormore arm mounts 608, and the carriages 602 within the base 604. Basecovers 610 may be translated and retracted open to deploy the carriages602, the arm mounts 608, and the arms 606 around the column 612, andclosed to stow and protect them when not in use. The base covers 610 maybe sealed with a membrane 614 along the edges of its opening to preventdirt and fluid ingress when closed.

FIG. 7A illustrates an embodiment of the robotically-enabled table-basedsystem 400 configured for a ureteroscopy procedure. In ureteroscopy, thetable 404 may include a swivel portion 702 for positioning a patientoff-angle from the column 402 and the table base 508. The swivel portion702 may rotate or pivot around a pivot point (e.g., located below thepatient's head) in order to position the bottom portion of the swivelportion 702 away from the column 402. For example, the pivoting of theswivel portion 702 allows a C-arm (not shown) to be positioned over thepatient's lower abdomen without competing for space with the column (notshown) below table 404. By rotating the carriage (not shown) around thecolumn 402, the robotic arms 406 may directly insert a ureteroscope 704along a virtual rail 706 into the patient's groin area to reach theurethra. In ureteroscopy, stirrups 708 may also be fixed to the swivelportion 702 of the table 404 to support the position of the patient'slegs during the procedure and allow clear access to the patient's groinarea.

FIG. 7B illustrates an embodiment of the system 400 configured for alaparoscopic procedure. In a laparoscopic procedure, through smallincision(s) in the patient's abdominal wall, minimally invasiveinstruments may be inserted into the patient's anatomy. In someembodiments, the minimally invasive instruments comprise an elongatedrigid member, such as a shaft, which is used to access anatomy withinthe patient. After inflation of the patient's abdominal cavity, theinstruments may be directed to perform surgical or medical tasks, suchas grasping, cutting, ablating, suturing, etc. In some embodiments, theinstruments can comprise a scope, such as a laparoscope. As shown inFIG. 7B, the carriages 502 of the system 400 may be rotated andvertically adjusted to position pairs of the robotic arms 406 onopposite sides of the table 404, such that an instrument 710 may bepositioned using the arm mounts 506 to be passed through minimalincisions on both sides of the patient to reach his/her abdominalcavity.

To accommodate laparoscopic procedures, the system 400 may also tilt theplatform to a desired angle. FIG. 7C illustrates an embodiment of thesystem 400 with pitch or tilt adjustment. As shown in FIG. 7C, thesystem 400 may accommodate tilt of the table 404 to position one portionof the table 404 at a greater distance from the floor than the other.Additionally, the arm mounts 506 may rotate to match the tilt such thatthe arms 406 maintain the same planar relationship with table 404. Toaccommodate steeper angles, the column 402 may also include telescopingportions 712 that allow vertical extension of the column 402 to keep thetable 404 from touching the floor or colliding with the base 508.

FIG. 8 provides a detailed illustration of the interface between thetable 404 and the column 402. Pitch rotation mechanism 802 may beconfigured to alter the pitch angle of the table 404 relative to thecolumn 402 in multiple degrees of freedom. The pitch rotation mechanism802 may be enabled by the positioning of orthogonal axes A and B at thecolumn-table interface, each axis actuated by a separate motor 804 a and804 b responsive to an electrical pitch angle command. Rotation alongone screw 806 a would enable tilt adjustments in one axis A, whilerotation along another screw 806 b would enable tilt adjustments alongthe other axis B. In some embodiments, a ball joint can be used to alterthe pitch angle of the table 404 relative to the column 402 in multipledegrees of freedom.

For example, pitch adjustments are particularly useful when trying toposition the table in a Trendelenburg position, i.e., position thepatient's lower abdomen at a higher position from the floor than thepatient's lower abdomen, for lower abdominal surgery. The Trendelenburgposition causes the patient's internal organs to slide towards his/herupper abdomen through the force of gravity, clearing out the abdominalcavity for minimally invasive tools to enter and perform lower abdominalsurgical or medical procedures, such as laparoscopic prostatectomy.

FIGS. 9A and 9B illustrate isometric and end views, respectively, of analternative embodiment of a table-based surgical robotics system 900.The surgical robotics system 900 includes one or more adjustable armsupports 902 that can be configured to support one or more robotic arms(see, for example, FIG. 9C) relative to a table 904. In the illustratedembodiment, a single adjustable arm support 902 is shown, though anadditional arm support can be provided on an opposite side of the table904. The adjustable arm support 902 can be configured so that it canmove relative to the table 904 to adjust and/or vary the position of theadjustable arm support 902 and/or any robotic arms mounted theretorelative to the table 904. For example, the adjustable arm support 902may be adjusted in one or more degrees of freedom relative to the table904. The adjustable arm support 902 provides high versatility to thesystem 900, including the ability to easily stow the one or moreadjustable arm supports 902 and any robotics arms attached theretobeneath the table 904. The adjustable arm support 902 can be elevatedfrom the stowed position to a position below an upper surface of thetable 904. In other embodiments, the adjustable arm support 902 can beelevated from the stowed position to a position above an upper surfaceof the table 904.

The adjustable arm support 902 can provide several degrees of freedom,including lift, lateral translation, tilt, etc. In the illustratedembodiment of FIGS. 9A and 9B, the arm support 902 is configured withfour degrees of freedom, which are illustrated with arrows in FIG. 9A. Afirst degree of freedom allows for adjustment of the adjustable armsupport 902 in the z-direction (“Z-lift”). For example, the adjustablearm support 902 can include a carriage 906 configured to move up or downalong or relative to a column 908 supporting the table 904. A seconddegree of freedom can allow the adjustable arm support 902 to tilt. Forexample, the adjustable arm support 902 can include a rotary joint,which can allow the adjustable arm support 902 to be aligned with thebed in a Trendelenburg position. A third degree of freedom can allow theadjustable arm support 902 to “pivot up,” which can be used to adjust adistance between a side of the table 904 and the adjustable arm support902. A fourth degree of freedom can permit translation of the adjustablearm support 902 along a longitudinal length of the table.

The surgical robotics system 900 in FIGS. 9A and 9B can comprise a table904 supported by a column 908 that is mounted to a base 910. The base910 and the column 908 support the table 904 relative to a supportsurface. A floor axis 912 and a support axis 914 are shown in FIG. 9B.

The adjustable arm support 902 can be mounted to the column 908. Inother embodiments, the arm support 902 can be mounted to the table 904or the base 910. The adjustable arm support 902 can include a carriage906, a bar or rail connector 916 and a bar or rail 918. In someembodiments, one or more robotic arms mounted to the rail 918 cantranslate and move relative to one another.

The carriage 906 can be attached to the column 908 by a first joint 920,which allows the carriage 906 to move relative to the column 908 (e.g.,such as up and down a first or vertical axis 922). The first joint 920can provide the first degree of freedom (“Z-lift”) to the adjustable armsupport 902. The adjustable arm support 902 can include a second joint924, which provides the second degree of freedom (tilt) for theadjustable arm support 902. The adjustable arm support 902 can include athird joint 926, which can provide the third degree of freedom (“pivotup”) for the adjustable arm support 902. An additional joint 928 (shownin FIG. 9B) can be provided that mechanically constrains the third joint926 to maintain an orientation of the rail 918 as the rail connector 916is rotated about a third axis 930. The adjustable arm support 902 caninclude a fourth joint 932, which can provide a fourth degree of freedom(translation) for the adjustable arm support 902 along a fourth axis934.

FIG. 9C illustrates an end view of the surgical robotics system 900 withtwo adjustable arm supports 902 a and 902 b mounted on opposite sides ofthe table 904. A first robotic arm 936 a is attached to the first bar orrail 918 a of the first adjustable arm support 902 a. The first roboticarm 936 a includes a base 938 a attached to the first rail 918 a. Thedistal end of the first robotic arm 936 a includes an instrument drivemechanism or input 940 a that can attach to one or more robotic medicalinstruments or tools. Similarly, the second robotic arm 936 b includes abase 938 a attached to the second rail 918 b. The distal end of thesecond robotic arm 936 b includes an instrument drive mechanism or input940 b configured to attach to one or more robotic medical instruments ortools.

In some embodiments, one or more of the robotic arms 936 a,b comprisesan arm with seven or more degrees of freedom. In some embodiments, oneor more of the robotic arms 936 a,b can include eight degrees offreedom, including an insertion axis (1-degree of freedom includinginsertion), a wrist (3-degrees of freedom including wrist pitch, yaw androll), an elbow (1-degree of freedom including elbow pitch), a shoulder(2-degrees of freedom including shoulder pitch and yaw), and base 938a,b (1-degree of freedom including translation). In some embodiments,the insertion degree of freedom can be provided by the robotic arm 936a,b, while in other embodiments, the instrument itself providesinsertion via an instrument-based insertion architecture.

C. Instrument Driver & Interface.

The end effectors of a system's robotic arms comprise (i) an instrumentdriver (alternatively referred to as “tool driver,” “instrument drivemechanism,” “instrument device manipulator,” and “drive input”) thatincorporate electro-mechanical means for actuating the medicalinstrument and, (ii) a removable or detachable medical instrument, whichmay be devoid of any electro-mechanical components, such as motors. Thisdichotomy may be driven by the need to sterilize medical instrumentsused in medical procedures, and the inability to adequately sterilizeexpensive capital equipment due to their intricate mechanical assembliesand sensitive electronics. Accordingly, the medical instruments may bedesigned to be detached, removed, and interchanged from the instrumentdriver (and thus the system) for individual sterilization or disposal bythe physician or the physician's staff. In contrast, the instrumentdrivers need not be changed or sterilized, and may be draped forprotection.

FIG. 10 illustrates an example instrument driver 1000, according to oneor more embodiments. Positioned at the distal end of a robotic arm, theinstrument driver 1000 comprises of one or more drive output 1002arranged with parallel axes to provide controlled torque to a medicalinstrument via corresponding drive shafts 1004. Each drive output 1002comprises an individual drive shaft 1004 for interacting with theinstrument, a gear head 1006 for converting the motor shaft rotation toa desired torque, a motor 1008 for generating the drive torque, and anencoder 1010 to measure the speed of the motor shaft and providefeedback to control circuitry 1012, which can also be used for receivingcontrol signals and actuating the drive output 1002. Each drive output1002 being independent controlled and motorized, the instrument driver1000 may provide multiple (at least two shown in FIG. 10 ) independentdrive outputs to the medical instrument. In operation, the controlcircuitry 1012 receives a control signal, transmits a motor signal tothe motor 1008, compares the resulting motor speed as measured by theencoder 1010 with the desired speed, and modulates the motor signal togenerate the desired torque.

For procedures that require a sterile environment, the robotic systemmay incorporate a drive interface, such as a sterile adapter connectedto a sterile drape, that sits between the instrument driver and themedical instrument. The chief purpose of the sterile adapter is totransfer angular motion from the drive shafts of the instrument driverto the drive inputs of the instrument while maintaining physicalseparation, and thus sterility, between the drive shafts and driveinputs. Accordingly, an example sterile adapter may comprise of a seriesof rotational inputs and outputs intended to be mated with the driveshafts of the instrument driver and drive inputs on the instrument.Connected to the sterile adapter, the sterile drape, comprised of athin, flexible material such as transparent or translucent plastic, isdesigned to cover the capital equipment, such as the instrument driver,robotic arm, and cart (in a cart-based system) or table (in atable-based system). Use of the drape would allow the capital equipmentto be positioned proximate to the patient while still being located inan area not requiring sterilization (i.e., non-sterile field). On theother side of the sterile drape, the medical instrument may interfacewith the patient in an area requiring sterilization (i.e., sterilefield).

D. Medical Instrument.

FIG. 11 illustrates an example medical instrument 1100 with a pairedinstrument driver 1102. Like other instruments designed for use with arobotic system, the medical instrument 1100 (alternately referred to asa “surgical tool”) comprises an elongated shaft 1104 (or elongate body)and an instrument base 1106. The instrument base 1106, also referred toas an “instrument handle” due to its intended design for manualinteraction by the physician, may generally comprise rotatable driveinputs 1108, e.g., receptacles, pulleys or spools, that are designed tobe mated with drive outputs 1110 that extend through a drive interfaceon the instrument driver 1102 at the distal end of a robotic arm 1112.When physically connected, latched, and/or coupled, the mated driveinputs 1108 of the instrument base 1106 may share axes of rotation withthe drive outputs 1110 in the instrument driver 1102 to allow thetransfer of torque from the drive outputs 1110 to the drive inputs 1108.In some embodiments, the drive outputs 1110 may comprise splines thatare designed to mate with receptacles on the drive inputs 1108.

The elongated shaft 1104 is designed to be delivered through either ananatomical opening or lumen, e.g., as in endoscopy, or a minimallyinvasive incision, e.g., as in laparoscopy. The elongated shaft 1104 maybe either flexible (e.g., having properties similar to an endoscope) orrigid (e.g., having properties similar to a laparoscope) or contain acustomized combination of both flexible and rigid portions. Whendesigned for laparoscopy, the distal end of a rigid elongated shaft 1104may be connected to an end effector of a surgical tool or medicalinstrument extending from a jointed wrist formed from a clevis with atleast one degree of freedom, such as, for example, a grasper orscissors, that may be actuated based on force from the tendons as thedrive inputs 1108 rotate in response to torque received from the driveoutputs 1110 of the instrument driver 1102. When designed for endoscopy,the distal end of the flexible elongated shaft 1104 may include asteerable or controllable bending section that may be articulated andbent based on torque received from the drive outputs 1110 of theinstrument driver 1102.

In some embodiments, torque from the instrument driver 1102 istransmitted down the elongated shaft 1104 using tendons along the shaft1104. These individual tendons, such as pull wires, may be individuallyanchored to individual drive inputs 1108 within the instrument handle1106. From the handle 1106, the tendons are directed down one or morepull lumens along the elongated shaft 1104 and anchored at the distalportion of the elongated shaft 1104, or in the wrist at the distalportion of the elongated shaft. During a surgical procedure, such as alaparoscopic, endoscopic, or a hybrid procedure, these tendons may becoupled to a distally mounted end effector, such as a wrist, a grasper,or scissors. Under such an arrangement, torque exerted on the driveinputs 1108 would transfer tension to the tendon, thereby causing theend effector to actuate in some way. In some embodiments, during asurgical procedure, the tendon may cause a joint to rotate about anaxis, thereby causing the end effector to move in one direction oranother. Alternatively, the tendon may be connected to one or more jawsof a grasper at distal end of the elongated shaft 1104, where tensionfrom the tendon cause the grasper to close.

In endoscopy, the tendons may be coupled to a bending or articulatingsection positioned along the elongated shaft 1104 (e.g., at the distalend) via adhesive, control ring, or other mechanical fixation. Whenfixedly attached to the distal end of a bending section, torque exertedon drive inputs 1108 would be transmitted down the tendons, causing thesofter, bending section (sometimes referred to as the articulablesection or region) to bend or articulate. Along the non-bendingsections, it may be advantageous to spiral or helix the individual pulllumens that direct the individual tendons along (or inside) the walls ofthe endoscope shaft to balance the radial forces that result fromtension in the pull wires. The angle of the spiraling and/or spacingthere between may be altered or engineered for specific purposes,wherein tighter spiraling exhibits lesser shaft compression under loadforces, while lower amounts of spiraling results in greater shaftcompression under load forces, but also exhibits limits bending. On theother end of the spectrum, the pull lumens may be directed parallel tothe longitudinal axis of the elongated shaft 1104 to allow forcontrolled articulation in the desired bending or articulable sections.

In endoscopy, the elongated shaft 1104 houses a number of components toassist with the robotic procedure. The shaft may comprise of a workingchannel for deploying surgical tools (or medical instruments),irrigation, and/or aspiration to the operative region at the distal endof the shaft 1104. The shaft 1104 may also accommodate wires and/oroptical fibers to transfer signals to/from an optical assembly at thedistal tip, which may include of an optical camera. The shaft 1104 mayalso accommodate optical fibers to carry light from proximally-locatedlight sources, such as light emitting diodes, to the distal end of theshaft.

At the distal end of the instrument 1100, the distal tip may alsocomprise the opening of a working channel for delivering tools fordiagnostic and/or therapy, irrigation, and aspiration to an operativesite. The distal tip may also include a port for a camera, such as afiberscope or a digital camera, to capture images of an internalanatomical space. Relatedly, the distal tip may also include ports forlight sources for illuminating the anatomical space when using thecamera.

In the example of FIG. 11 , the drive shaft axes, and thus the driveinput axes, are orthogonal to the axis of the elongated shaft. Thisarrangement, however, complicates roll capabilities for the elongatedshaft 1104. Rolling the elongated shaft 1104 along its axis whilekeeping the drive inputs 1108 static results in undesirable tangling ofthe tendons as they extend off the drive inputs 1108 and enter pulllumens within the elongated shaft 1104. The resulting entanglement ofsuch tendons may disrupt any control algorithms intended to predictmovement of the flexible elongated shaft during an endoscopic procedure.

FIG. 12 illustrates an alternative design for a circular instrumentdriver 1200 and corresponding instrument 1202 (alternately referred toas a “surgical tool”) where the axes of the drive units are parallel tothe axis of the elongated shaft 1206 of the instrument 1202. As shown,the instrument driver 1200 comprises four drive units with correspondingdrive outputs 1208 aligned in parallel at the end of a robotic arm 1210.The drive units and their respective drive outputs 1208 are housed in arotational assembly 1212 of the instrument driver 1200 that is driven byone of the drive units within the assembly 1212. In response to torqueprovided by the rotational drive unit, the rotational assembly 1212rotates along a circular bearing that connects the rotational assembly1212 to a non-rotational portion 1214 of the instrument driver 1200.Power and control signals may be communicated from the non-rotationalportion 1214 of the instrument driver 1200 to the rotational assembly1212 through electrical contacts maintained through rotation by abrushed slip ring connection (not shown). In other embodiments, therotational assembly 1212 may be responsive to a separate drive unit thatis integrated into the non-rotatable portion 1214, and thus not inparallel with the other drive units. The rotational assembly 1212 allowsthe instrument driver 1200 to rotate the drive units and theirrespective drive outputs 1208 as a single unit around an instrumentdriver axis 1216.

Like earlier disclosed embodiments, the instrument 1202 may include anelongated shaft 1206 and an instrument base 1218 (shown in phantom)including a plurality of drive inputs 1220 (such as receptacles,pulleys, and spools) that are configured to mate with the drive outputs1208 of the instrument driver 1200. Unlike prior disclosed embodiments,the instrument shaft 1206 extends from the center of the instrument base1218 with an axis substantially parallel to the axes of the drive inputs1220, rather than orthogonal as in the design of FIG. 11 .

When coupled to the rotational assembly 1212 of the instrument driver1200, the medical instrument 1202, comprising instrument base 1218 andinstrument shaft 1206, rotates in combination with the rotationalassembly 1212 about the instrument driver axis 1216. Since theinstrument shaft 1206 is positioned at the center of the instrument base1218, the instrument shaft 1206 is coaxial with the instrument driveraxis 1216 when attached. Thus, rotation of the rotational assembly 1212causes the instrument shaft 1206 to rotate about its own longitudinalaxis. Moreover, as the instrument base 1218 rotates with the instrumentshaft 1206, any tendons connected to the drive inputs 1220 in theinstrument base 1218 are not tangled during rotation. Accordingly, theparallelism of the axes of the drive outputs 1208, the drive inputs1220, and the instrument shaft 1206 allows for the shaft rotationwithout tangling any control tendons.

FIG. 13 illustrates a medical instrument 1300 having an instrument basedinsertion architecture in accordance with some embodiments. Theinstrument 1300 (alternately referred to as a “surgical tool”) can becoupled to any of the instrument drivers discussed herein above and, asillustrated, can include an elongated shaft 1302, an end effector 1304connected to the shaft 1302, and a handle 1306 coupled to the shaft1302. The elongated shaft 1302 comprises a tubular member having aproximal portion 1308 a and a distal portion 1308 b. The elongated shaft1302 comprises one or more channels or grooves 1310 along its outersurface and configured to receive one or more wires or cables 1312therethrough. One or more cables 1312 thus run along an outer surface ofthe elongated shaft 1302. In other embodiments, the cables 1312 can alsorun through the elongated shaft 1302. Manipulation of the cables 1312(e.g., via an instrument driver) results in actuation of the endeffector 1304.

The instrument handle 1306, which may also be referred to as aninstrument base, may generally comprise an attachment interface 1314having one or more mechanical inputs 1316, e.g., receptacles, pulleys orspools, that are designed to be reciprocally mated with one or moretorque couplers on an attachment surface of an instrument driver.

In some embodiments, the instrument 1300 comprises a series of pulleysor cables that enable the elongated shaft 1302 to translate relative tothe handle 1306. In other words, the instrument 1300 itself comprises aninstrument-based insertion architecture that accommodates insertion ofthe instrument, thereby minimizing the reliance on a robot arm toprovide insertion of the instrument 1300. In other embodiments, arobotic arm can be largely responsible for instrument insertion.

E. Controller.

Any of the robotic systems described herein can include an input deviceor controller for manipulating an instrument attached to a robotic arm.In some embodiments, the controller can be coupled (e.g.,communicatively, electronically, electrically, wirelessly and/ormechanically) with an instrument such that manipulation of thecontroller causes a corresponding manipulation of the instrument e.g.,via master slave control.

FIG. 14 is a perspective view of an embodiment of a controller 1400. Inthe present embodiment, the controller 1400 comprises a hybridcontroller that can have both impedance and admittance control. In otherembodiments, the controller 1400 can utilize just impedance or passivecontrol. In other embodiments, the controller 1400 can utilize justadmittance control. By being a hybrid controller, the controller 1400advantageously can have a lower perceived inertia while in use.

In the illustrated embodiment, the controller 1400 is configured toallow manipulation of two medical instruments, and includes two handles1402. Each of the handles 1402 is connected to a gimbal 1404, and eachgimbal 1404 is connected to a positioning platform 1406.

As shown in FIG. 14 , each positioning platform 1406 includes aselective compliance assembly robot arm (SCARA) 1408 coupled to a column1410 by a prismatic joint 1412. The prismatic joints 1412 are configuredto translate along the column 1410 (e.g., along rails 1414) to alloweach of the handles 1402 to be translated in the z-direction, providinga first degree of freedom. The SCARA arm 1408 is configured to allowmotion of the handle 1402 in an x-y plane, providing two additionaldegrees of freedom.

In some embodiments, one or more load cells are positioned in thecontroller 1400. For example, in some embodiments, a load cell (notshown) is positioned in the body of each of the gimbals 1404. Byproviding a load cell, portions of the controller 1400 are capable ofoperating under admittance control, thereby advantageously reducing theperceived inertia of the controller 1400 while in use. In someembodiments, the positioning platform 1406 is configured for admittancecontrol, while the gimbal 1404 is configured for impedance control. Inother embodiments, the gimbal 1404 is configured for admittance control,while the positioning platform 1406 is configured for impedance control.Accordingly, for some embodiments, the translational or positionaldegrees of freedom of the positioning platform 1406 can rely onadmittance control, while the rotational degrees of freedom of thegimbal 1404 rely on impedance control.

F. Navigation and Control.

Traditional endoscopy may involve the use of fluoroscopy (e.g., as maybe delivered through a C-arm) and other forms of radiation-based imagingmodalities to provide endoluminal guidance to an operator physician. Incontrast, the robotic systems contemplated by this disclosure canprovide for non-radiation-based navigational and localization means toreduce physician exposure to radiation and reduce the amount ofequipment within the operating room. As used herein, the term“localization” may refer to determining and/or monitoring the positionof objects in a reference coordinate system. Technologies such aspre-operative mapping, computer vision, real-time EM tracking, and robotcommand data may be used individually or in combination to achieve aradiation-free operating environment. In other cases, whereradiation-based imaging modalities are still used, the pre-operativemapping, computer vision, real-time EM tracking, and robot command datamay be used individually or in combination to improve upon theinformation obtained solely through radiation-based imaging modalities.

FIG. 15 is a block diagram illustrating a localization system 1500 thatestimates a location of one or more elements of the robotic system, suchas the location of the instrument, in accordance to an exampleembodiment. The localization system 1500 may be a set of one or morecomputer devices configured to execute one or more instructions. Thecomputer devices may be embodied by a processor (or processors) andcomputer-readable memory in one or more components discussed above. Byway of example and not limitation, the computer devices may be in thetower 112 shown in FIG. 1 , the cart 102 shown in FIGS. 1-3B, the bedsshown in FIGS. 4-9 , etc.

As shown in FIG. 15 , the localization system 1500 may include alocalization module 1502 that processes input data 1504 a, 1504 b, 1504c, and 1504 d to generate location data 1506 for the distal tip of amedical instrument. The location data 1506 may be data or logic thatrepresents a location and/or orientation of the distal end of theinstrument relative to a frame of reference. The frame of reference canbe a frame of reference relative to the anatomy of the patient or to aknown object, such as an EM field generator (see discussion below forthe EM field generator).

The various input data 1504 a-d are now described in greater detail.Pre-operative mapping may be accomplished through the use of thecollection of low dose CT scans. Pre-operative CT scans arereconstructed into three-dimensional images, which are visualized, e.g.as “slices” of a cutaway view of the patient's internal anatomy. Whenanalyzed in the aggregate, image-based models for anatomical cavities,spaces and structures of the patient's anatomy, such as a patient lungnetwork, may be generated. Techniques such as center-line geometry maybe determined and approximated from the CT images to develop athree-dimensional volume of the patient's anatomy, referred to as modeldata 1504 a (also referred to as “preoperative model data” whengenerated using only preoperative CT scans). The use of center-linegeometry is discussed in U.S. patent application Ser. No. 14/523,760,the contents of which are herein incorporated in its entirety. Networktopological models may also be derived from the CT-images, and areparticularly appropriate for bronchoscopy.

In some embodiments, the instrument may be equipped with a camera toprovide vision data 1504 b. The localization module 1502 may process thevision data 1504 b to enable one or more vision-based location tracking.For example, the preoperative model data may be used in conjunction withthe vision data 1504 b to enable computer vision-based tracking of themedical instrument (e.g., an endoscope or an instrument advance througha working channel of the endoscope). For example, using the preoperativemodel data 1504 a, the robotic system may generate a library of expectedendoscopic images from the model based on the expected path of travel ofthe endoscope, each image linked to a location within the model.Intra-operatively, this library may be referenced by the robotic systemin order to compare real-time images captured at the camera (e.g., acamera at a distal end of the endoscope) to those in the image libraryto assist localization.

Other computer vision-based tracking techniques use feature tracking todetermine motion of the camera, and thus the endoscope. Some features ofthe localization module 1502 may identify circular geometries in thepreoperative model data 1504 a that correspond to anatomical lumens andtrack the change of those geometries to determine which anatomical lumenwas selected, as well as the relative rotational and/or translationalmotion of the camera. Use of a topological map may further enhancevision-based algorithms or techniques.

Optical flow, another computer vision-based technique, may analyze thedisplacement and translation of image pixels in a video sequence in thevision data 1504 b to infer camera movement. Examples of optical flowtechniques may include motion detection, object segmentationcalculations, luminance, motion compensated encoding, stereo disparitymeasurement, etc. Through the comparison of multiple frames overmultiple iterations, movement and location of the camera (and thus theendoscope) may be determined.

The localization module 1502 may use real-time EM tracking to generate areal-time location of the endoscope in a global coordinate system thatmay be registered to the patient's anatomy, represented by thepreoperative model. In EM tracking, an EM sensor (or tracker) comprisingof one or more sensor coils embedded in one or more locations andorientations in a medical instrument (e.g., an endoscopic tool) measuresthe variation in the EM field created by one or more static EM fieldgenerators positioned at a known location. The location informationdetected by the EM sensors is stored as EM data 1504 c. The EM fieldgenerator (or transmitter), may be placed close to the patient to createa low intensity magnetic field that the embedded sensor may detect. Themagnetic field induces small currents in the sensor coils of the EMsensor, which may be analyzed to determine the distance and anglebetween the EM sensor and the EM field generator. These distances andorientations may be intra-operatively “registered” to the patientanatomy (e.g., the preoperative model) in order to determine thegeometric transformation that aligns a single location in the coordinatesystem with a position in the pre-operative model of the patient'sanatomy. Once registered, an embedded EM tracker in one or morepositions of the medical instrument (e.g., the distal tip of anendoscope) may provide real-time indications of the progression of themedical instrument through the patient's anatomy.

Robotic command and kinematics data 1504 d may also be used by thelocalization module 1502 to provide localization data 1506 for therobotic system. Device pitch and yaw resulting from articulationcommands may be determined during pre-operative calibration.Intra-operatively, these calibration measurements may be used incombination with known insertion depth information to estimate theposition of the instrument. Alternatively, these calculations may beanalyzed in combination with EM, vision, and/or topological modeling toestimate the position of the medical instrument within the network.

As FIG. 15 shows, a number of other input data can be used by thelocalization module 1502. For example, although not shown in FIG. 15 ,an instrument utilizing shape-sensing fiber can provide shape data thatthe localization module 1502 can use to determine the location and shapeof the instrument.

The localization module 1502 may use the input data 1504 a-d incombination(s). In some cases, such a combination may use aprobabilistic approach where the localization module 1502 assigns aconfidence weight to the location determined from each of the input data1504 a-d. Thus, where the EM data 1504 c may not be reliable (as may bethe case where there is EM interference) the confidence of the locationdetermined by the EM data 1504 c can be decrease and the localizationmodule 1502 may rely more heavily on the vision data 1504 b and/or therobotic command and kinematics data 1504 d.

As discussed above, the robotic systems discussed herein may be designedto incorporate a combination of one or more of the technologies above.The robotic system's computer-based control system, based in the tower,bed and/or cart, may store computer program instructions, for example,within a non-transitory computer-readable storage medium such as apersistent magnetic storage drive, solid state drive, or the like, that,upon execution, cause the system to receive and analyze sensor data anduser commands, generate control signals throughout the system, anddisplay the navigational and localization data, such as the position ofthe instrument within the global coordinate system, anatomical map, etc.

2. Introduction

Embodiments of the disclosure relate to systems and techniques formanually activating a surgical tool and manually bailing out thesurgical tool. The surgical tool may comprise a drive housing having afirst end and a second end, a spline extending between the first andsecond ends and being rotatably coupled to the first end at a driveinput, a drive gear coupled to and rotatable with the spline, a carriagemovably mounted to the spline and housing an activating mechanismoperatively coupled to the drive gear such that rotation of the splineactuates the activating mechanism, and a bailout mechanism arranged atthe second end. The bailout mechanism may include a lever that ismovable relative to the spline, from a first position, where the splineis disengaged from the lever, to a second position, where the splineengages the lever such that rotation of the lever correspondinglyrotates the spline.

3. Description

FIG. 16 is an isometric side view of an example surgical tool 1600 thatmay incorporate some or all of the principles of the present disclosure.The surgical tool 1600 may be similar in some respects to any of themedical instruments described above with reference to FIGS. 11-13 and,therefore, may be used in conjunction with a robotic surgical system,such as the robotically-enabled systems 100, 400, and 900 of FIGS. 1-13. As illustrated, the surgical tool 1600 includes an elongated shaft1602, an end effector 1604 arranged at the distal end of the shaft 1602,and an articulable wrist 1606 (alternately referred to as a “wristjoint”) that couples the end effector 1604 to the distal end of theshaft 1602.

The terms “proximal” and “distal” are defined herein relative to arobotic surgical system having an interface configured to mechanicallyand electrically couple the surgical tool 1600 to a robotic manipulator.The term “proximal” refers to the position of an element closer to therobotic manipulator and the term “distal” refers to the position of anelement closer to the end effector 1604 and thus closer to the patientduring operation. Moreover, the use of directional terms such as above,below, upper, lower, upward, downward, left, right, and the like areused in relation to the illustrative embodiments as they are depicted inthe figures, the upward or upper direction being toward the top of thecorresponding figure and the downward or lower direction being towardthe bottom of the corresponding figure.

The surgical tool 1600 can have any of a variety of configurationscapable of performing one or more surgical functions. In the illustratedembodiment, the end effector 1604 comprises a surgical stapler,alternately referred to as an “endocutter,” configured to cut and staple(fasten) tissue. As illustrated, the end effector 1604 includes opposingjaws 1610, 1612 configured to move (articulate) between open and closedpositions. Alternatively, the end effector 1604 may comprise other typesof instruments requiring the opposing jaws 1610, 1612 such as, but notlimited to, tissue graspers, surgical scissors, advanced energy vesselsealers, clip appliers, needle drivers, a babcock including a pair ofopposed grasping jaws, bipolar jaws (e.g., bipolar Maryland grasper,forceps, a fenestrated grasper, etc.), etc. In other embodiments, theend effector 1604 may instead comprise any end effector or instrumentcapable of being operated in conjunction with the presently disclosedrobotic surgical systems and methods. Such end effectors or instrumentsinclude, but are not limited to, a suction irrigator, an endoscope(e.g., a camera), a probe, a scope, an advanced imaging system, or anycombination thereof.

One or both of the jaws 1610, 1612 may be configured to pivot to actuatethe end effector 1604 between open and closed positions. In theillustrated example, the second jaw 1612 is rotatable (pivotable)relative to the first jaw 1610 to move between an open, unclampedposition and a closed, clamped position. In other embodiments, however,the first jaw 1610 may move (rotate) relative to the second jaw 1612,without departing from the scope of the disclosure. In yet otherembodiments, both jaws 1610, 1612 may move to actuate the end effector1604 between open and closed positions.

In the illustrated example, the first jaw 1610 may be characterized orotherwise referred to as a “cartridge” jaw, and the second jaw 1612 maybe characterized or otherwise referred to as an “anvil” jaw. The firstjaw 1610 may include a frame that houses or supports a staple cartridge,and the second jaw 1612 is pivotally supported relative to the first jaw1610 and defines a surface that operates as an anvil to deform staplesejected from the staple cartridge during operation.

The wrist 1606 enables the end effector 1604 to articulate (pivot)relative to the shaft 1602 and thereby position the end effector 1604 atvarious desired orientations and locations relative to a surgical site.In the illustrated embodiment, the wrist 1606 is designed to allow theend effector 1604 to pivot (swivel) left and right relative to alongitudinal axis A₁ of the shaft 1602. In other embodiments, however,the wrist 1606 may be designed to provide multiple degrees of freedom,including one or more translational variables (i.e., surge, heave, andsway) and/or one or more rotational variables (i.e., Euler angles orroll, pitch, and yaw). The translational and rotational variablesdescribe the position and orientation of a component of a surgicalsystem (e.g., the end effector 1604) with respect to a given referenceCartesian frame. “Surge” refers to forward and backward translationalmovement, “heave” refers to translational movement up and down, and“sway” refers to translational movement left and right. With regard tothe rotational terms, “roll” refers to tilting side to side, “pitch”refers to tilting forward and backward, and “yaw” refers to turning leftand right.

In the illustrated embodiment, the pivoting motion at the wrist 1606 islimited to movement in a single plane, e.g., only yaw movement relativeto the longitudinal axis A₁. The end effector 1604 is depicted in FIG.16 in the unarticulated position where a longitudinal axis of the endeffector 1604 is substantially aligned with the longitudinal axis A₁ ofthe shaft 1602, such that the end effector 1604 is at a substantiallyzero angle relative to the shaft 1602. In the articulated position, thelongitudinal axis of the end effector 1604 would be angularly offsetfrom the longitudinal axis A₁ such that the end effector 1604 would beoriented at a non-zero angle relative to the shaft 1602.

Still referring to FIG. 16 , the surgical tool 1600 may include a drivehousing 1614, alternately referred to as a “stage,” that operates as anactuation system designed to facilitate articulation of the wrist 1606and actuation (operation) of the end effector 1604 (e.g., clamping,firing, rotation, articulation, energy delivery, etc.). As described inmore detail below, the drive housing 1614 includes coupling featuresthat releasably couple the surgical tool 1600 to an instrument driver ofa robotic surgical system.

The drive housing 1614 includes a plurality of drive members (obscuredin FIG. 16 ) that extend to the wrist 1606 and the end effector 1604.Selective actuation of some drive members causes the end effector 1604to articulate (pivot) relative to the shaft 1602 at the wrist 1606.Selective actuation of other drive members cause the end effector 1604to actuate (operate). Actuating the end effector 1604 may includeclosing and/or opening the second jaw 1612 relative to the first jaw1610 (or vice versa), thereby enabling the end effector 1604 to grasp(clamp) onto tissue. Once tissue is grasped or clamped between theopposing jaws 1610, 1612, actuating the end effector 1604 may furtherinclude “firing” the end effector 1604, which may refer to causing acutting element or knife (not visible) to advance distally within a slot(obscured from view) defined in the first jaw 1610. As it movesdistally, the cutting element transects any tissue grasped between theopposing jaws 1610, 1612. Moreover, as the cutting element advancesdistally, a plurality of staples contained within the staple cartridge(e.g., housed within the first jaw 1610) are urged (cammed) intodeforming contact with corresponding anvil surfaces (e.g., pockets)provided on the second jaw 1612. The deployed staples may form multiplerows of staples that seal opposing sides of the transected tissue.

As illustrated, the drive housing 1614 has a first or “distal” end 1618a and a second or “proximal” end 1618 b opposite the first end 1618 a.The first end 1618 a is alternately referred to as the “handle”. In someembodiments, one or more struts 1620 (two shown) extend longitudinallybetween the first and second ends 1618 a,b to help fix the distancebetween the first and second ends 1618 a,b and provide structuralstability to the drive housing 1614. In other embodiments, however, thestruts 1620 may be omitted, without departing from the scope of thedisclosure.

A lead screw 1622 and one or more splines 1624 also extendlongitudinally between the first and second ends 1618 a,b. In theillustrated embodiment, the drive housing 1614 includes a first spline1624 a, a second spline 1624 b, and a third spline 1624 c. While threesplines 1624 a-c are depicted, more or less than three may be includedin the drive housing 1614, without departing from the scope of thedisclosure. Unlike the struts 1620, the lead screw 1622 and the splines1624 a-c are rotatably mounted to the first and second ends 1618 a,b. Asdescribed in more detail below, selective rotation of the lead screw1622 and the splines 1624 a-c causes actuation of various componentswithin the drive housing 1614, which thereby causes various functions ofthe surgical tool 1600 to transpire, for example, such as translatingthe end effector 1604 along the longitudinal axis A₁, causing the endeffector 1604 to articulate (pivot) at the wrist 1606, and causing theend effector 1604 to actuate (operate).

The drive housing 1614 further includes a carriage or “kart” 1626movably mounted along the lead screw 1622 and the splines 1624 a-c andhousing various activating mechanisms configured to cause operation ofspecific functions of the end effector 1604. The carriage 1626 maycomprise two or more layers, shown in FIG. 16 as a first layer 1628 a, asecond layer 1628 b, a third layer 1628 c, a fourth layer 1628 d, and afifth layer 1628 e. While five layers 1628 a-e are depicted, more orless than five may be included in the carriage 1626, without departingfrom the scope of the disclosure.

In addition, one or more of the layers 1628 a-e of the carriage 1626 maybe detachable relative to the remaining layers 1628 a-e. In this manner,one or more of the layers 1628 a-e of the carriage 1626 may be securedtogether as a block of layers that may be releasably secured to theremaining layer(s) to define the carriage 1628. For example, some of thelayers 1628 a-e may be integrally secured together in series, to form ablock of layers, and such block of layers may be selectively secured tothe remaining one or more layers 1628 a-e that are not integrallysecured to the block of layers. In the illustrated embodiment, thelayers 1628 b-e are secured to each other in series using one or moremechanical fasteners 1630 (one visible) extending between the secondlayer 1628 b and the fifth layer 1628 e and through coaxially alignedholes in each layer 1628 b-e to form a block of layers configured to bereleasably secured to the first layer 1628 a, as described below. In theillustrated example, one or more snaps 1632 (two visible) are utilizedto align (or clock) and releasably attach the block of layers 1628 b-eto the first layer 1628 a, as further described below, but various othertypes of one or more releasable connector(s) may be utilized.

While four layers 1628 b-e are depicted as being secured together viathe mechanical fastener(s) 1630 to define the block of secured-togetherlayers 1628 b-e releasably attached to the first layer 1628 a via thesnaps 1632, the block of secured-together layers may include more orless than four layers, without departing from the scope of thedisclosure. Moreover, one or more additional layers may be mechanicallyfastened in series to the first layer 1628 a (e.g., the second layer1628 b) to define a second block of secured-together layers that isreleasably attached to the first block of secured-together layers (e.g.,the three layers 1628 c-e), without departing from the scope of thedisclosure. As further described below, configuring the carriage 1626with one or more layers that are releasably secured relative to theremaining layers will provide a degree of modularity to the surgicaltool 1600 to thereby allow one or more components of the surgical tool1600 to be interchangeable, reusable, and/or replaceable.

The shaft 1602 is coupled to and extends distally from the carriage 1626through the first end 1618 a of the drive housing 1614. In theillustrated embodiment, for example, the shaft 1602 penetrates the firstend 1618 a at a central aperture defined through the first end 1618 a.The carriage 1626 is movable between the first and second ends 1618 a,balong the longitudinal axis A₁ and is thereby able to advance or retractthe end effector 1604 relative to the drive housing 1614, as indicatedby the arrows B. More specifically, in some embodiments, the carriage1626 includes a carriage nut 1634 mounted to the lead screw 1622 andsecured with respect to the first layer 1628 a. In this manner, thefirst layer 1628 a of the carriage 1626 may define an elevator uponwhich the other layers 1628 b-e releasably attached thereon may betranslated, as described below. The outer surface of the lead screw 1622defines helical threading and the carriage nut 1634 definescorresponding internal helical threading (not shown) matable with theouter helical threading of the lead screw 1622. As a result, rotation ofthe lead screw 1622 causes the carriage nut 1634 to advance or retractthe carriage 1626 along the longitudinal axis A₁ and correspondinglyadvance or retract the end effector 1604 relative to the drive housing1614.

As indicated above, the lead screw 1622 and the splines 1624 a-c arerotatably mounted to the first and second ends 1618 a,b. Morespecifically, the first end 1618 a of the drive housing 1614 may includeone or more rotatable drive inputs, shown as a first drive input 1636 a,a second drive input 1636 b, a third drive input 1636 c, and a fourthdrive input 1636 d. As discussed in more detail below, each drive input1636 a-d may be matable with a corresponding drive output of aninstrument driver such that movement (rotation) of a given drive outputcorrespondingly moves (rotates) the associated drive input 1636 a-d.

The first drive input 1636 a may be operatively coupled to the leadscrew 1622 such that rotation of the first drive input 1636 acorrespondingly rotates the lead screw 1622, which causes the carriagenut 1634 and the first layer 1628 a constraining the carriage nut 1634to advance or retract along the longitudinal axis A₁, depending on therotational direction of the lead screw 1622. Moreover, as describedherein the first layer 1628 a of the carriage 1626 may be configured asan elevator (of the carriage 1626) that translates the remaining layers1628 b-e of the carriage 1626 releasably connected to the first layer1628 a. Thus, when the remaining layers 1628 b-e are installed on thefirst layer 1628 a, to thereby define the carriage 1626 as depicted inFIG. 16 , rotation of the first drive input 1636 a correspondinglyrotates the lead screw 1622, which causes the entirety of the carriage1626 now fully coupled to the carriage nut 1634, to advance or retractalong the longitudinal axis A₁, depending on the rotational direction ofthe lead screw 1622.

The second drive input 1636 b may be operatively coupled to the firstspline 1624 a such that rotation of the second drive input 1636 bcorrespondingly rotates the first spline 1624 a. In some embodiments,the first spline 1624 a may be operatively coupled to a first activatingmechanism 1638 a of the carriage 1626, and the first activatingmechanism 1638 a may be operable to open and close the jaws 1610, 1612.Accordingly, rotating the second drive input 1636 b will correspondinglyactuate the first activating mechanism 1638 a and open or close the jaws1610, 1612, depending on the rotational direction of the first spline1624 a. In addition, the second layer 1628 b is configured toaccommodate the first activating mechanism 1638 a such that the jaws1610, 1612 are operable as described herein and, in the illustratedexample, the first activating mechanism 1638 a is at least partiallyconstrained by the second layer 1628 b and the third layer 1628 c.

The third drive input 1636 c may be operatively coupled to the secondspline 1624 b such that rotation of the third drive input 1636 ccorrespondingly rotates the second spline 1624 b. In some embodiments,the second spline 1624 b may be operatively coupled to a secondactivating mechanism 1638 b of the carriage 1626, and the secondactivating mechanism 1638 b may be operable to articulate the endeffector 1604 at the wrist 1606. Accordingly, rotating the third driveinput 1636 c will correspondingly actuate the second activatingmechanism 1638 b and cause the wrist 1606 to articulate in at least onedegree of freedom, depending on the rotational direction of the secondspline 1624 b. In addition, the third layer 1628 c is configured toaccommodate the second activating mechanism 1638 b for articulation ofthe wrist 1606 as described herein and, in the illustrated example, thesecond activating mechanism 1638 b is at least partially constrained bythe third layer 1628 c and the fourth layer 1628 d.

The fourth drive input 1636 d may be operatively coupled to the thirdspline 1624 c such that rotation of the fourth drive input 1636 dcorrespondingly rotates the third spline 1624 c. In some embodiments,the third spline 1624 c may be operatively coupled to a third activatingmechanism 1638 c of the carriage 1626, and the third activatingmechanism 1638 c may be operable to translate a drive bar (see FIGS.30-31 ) extending within the elongate shaft 1602 and thereby fire thecutting element (knife) at the end effector 1604. Accordingly, rotatingthe fourth drive input 1636 d will correspondingly actuate the thirdactivating mechanism 1638 c and cause the knife to advance or retract,depending on the rotational direction of the third spline 1624 c. Inaddition, the fifth layer 1628 e is configured to accommodate the thirdactivating mechanism 1638 c for firing the cutting element of the endeffector 1604 as described herein and, in the illustrated example, thethird activating mechanism 1638 c is at least partially constrained bythe fifth layer 1628 e and a thrust bearing layer 1628 f of the carriage1626.

In the illustrated embodiment, the activating mechanisms 1638 a-ccomprise intermeshed gearing assemblies including one or more drivegears driven by rotation of the corresponding spline 1624 a-c andconfigured to drive one or more corresponding driven gears that causeoperation of specific functions of the end effector 1604.

In some embodiments, the layers 1628 b-e are secured to the shaft 1602and the activating mechanisms 1638 a-c are operatively housed withintheir associated layer 1628 b-e so as to actuate the surgical tool 1600as described herein. In the illustrated embodiment, the layers 1628 b-eare fastened together with the mechanical fastener(s) 1630 to constrainthe associated activating mechanisms 1638 a-c in positions where theyintermesh to provide functionality at the end effector 1604 and thewrist 1606. Here, the first layer 1628 a of the carriage 1626, the leadscrew 1622, and the carriage nut 1634 are operatively secured within (orto) the drive housing 1614, such that the first layer 1628 a defines anelevator onto which the other layers 1628 b-e may be releasably securedwhen assembly the surgical tool 1600.

FIG. 16 illustrates an embodiment of the drive housing 1614 having ashroud 1640 that defines a periphery of the drive housing 1614 forhandling and manipulation by the operator or user. In the illustratedembodiment, the shroud 1640 is depicted as a transparent material (or atleast a partially transparent material), such that the internalcomponents of the drive housing 1614 are visible through the shroud1640. However, in other examples, the shroud 1640 need not betransparent. Where included, the shroud 1640 may be sized to receive thelead screw 1622, the splines 1624 a-c, and the carriage 1626, as well asother internal components of the drive housing 1614.

In some embodiments, the shroud 1640 may be incorporated in a shroudassembly of the drive housing 1614. FIG. 17 is an isometric view of thesurgical tool 1600 of FIG. 16 illustrating the drive housing 1614 whenpartially disassembled, according to one or more embodiments. Inparticular, FIG. 17 depicts an exemplary shroud assembly 1700 of thedrive housing 1614 incorporating the shroud 1640 when disassembled fromthe remaining portion of the drive housing 1614, according to one ormore embodiments. In the illustrated embodiment, the shroud assembly1700 defines a tubular or cylindrical structure having (i) a first end1702 a matable with the first end 1618 a of the drive housing 1614 and(ii) a second end 1702 b opposite the first end 1702 a and matable withthe second end 1618 b of the drive housing 1614. The carriage 1626, thelead screw 1622, and the splines 1624 a-c may all be accommodated withinthe interior of the shroud 1640, and the carriage 1626 may engage andride on one or more rails 1704 (sometimes referred to as guide rails)coupled to the shroud 1640. The rails 1704 extend longitudinally andparallel to the lead screw 1622, and the rails 1704 are sized to bereceived within corresponding notches 1706 defined on the outerperiphery of the carriage 1626 and, more particularly, on one or more ofthe layers 1628 a-e. As the carriage 1626 translates along thelongitudinal axis A₁, the rails 1704 help maintain the angular positionof the carriage 1626 and assume any torsional loading that wouldotherwise adversely affect the carriage 1626. In addition, the shroud1640 may include one or more alignment notches 1708 for aligning thesecond end 1618 b on the shroud assembly 1700. The rails 1704 may befastened within an interior of the shroud 1640 and, in the illustratedexamples, are coupled within the interior of the shroud 1640 viaexterior rails 1710 positioned exterior the shroud 1640 and connected tothe (guide) rails 1704 via a plurality of fasteners 1712 that extendthrough the shroud 1640.

FIG. 18A is an isometric view of the surgical tool 1600 of FIGS. 16 and17 releasably coupled to an example instrument driver 1800, according toone or more embodiments. The instrument driver 1800 may be similar insome respects to the instrument drivers 1102, 1200 of FIGS. 11 and 12 ,respectively, and therefore may be best understood with referencethereto. Similar to the instrument drivers 1102, 1200, for example, theinstrument driver 1800 may be mounted to or otherwise positioned at theend of a robotic arm (not shown) and designed to provide the motiveforces required to operate the surgical tool 1600. Unlike the instrumentdrivers 1102, 1200, however, the shaft 1602 of the surgical tool 1600extends through and penetrates the instrument driver 1800.

The instrument driver 1800 has a body 1802 having a first or “proximal”end 1804 a and a second or “distal” end 1804 b opposite the first end1804 a. In the illustrated embodiment, the first end 1804 a of theinstrument driver 1800 is matable with the first end 1618 a of the drivehousing 1614, and the shaft 1602 of the surgical tool 1602 extends intothe first end 1804 a, through the body 1802, and distally from thesecond end 1804 b of the body 1802.

FIG. 18B provides separated isometric end views of the first end 1804 aof the instrument driver 1800 and the first end 1618 a of the drivehousing 1614 of the surgical tool 1600 of FIGS. 16 and 17 . With thejaws 1610, 1612 closed, the shaft 1602 and the end effector 1604 aredesigned to penetrate the instrument driver 1800 by extending through acentral aperture 1806 defined longitudinally through the body 1802between the first and second ends 1804 a,b. To angularly align thesurgical tool 1600 with the instrument driver 1800 in a proper angularorientation, one or more alignment guides 1808 may be provided orotherwise defined within the central aperture 1806 and configured toengage one or more corresponding alignment features 1810 provided by thesurgical tool 1600 (obscured from view, see FIG. 17 ). In theillustrated embodiment, the alignment feature 1810 comprises aprotrusion or projection defined on or otherwise provided by analignment nozzle 1812 extending distally from the first end 1618 a ofthe drive housing 1614. In one or more embodiments, the alignment guide1808 may comprise a curved or arcuate shoulder configured to receive thealignment feature 1810 as the shaft 1602 enters the central aperture1806 and guide the surgical tool 1600 to a proper angular alignment withthe instrument driver 1800 as the shaft 1602 is advanced distallythrough the central aperture 1806.

In addition, one or more additional alignment features 1814 may bearranged within the central aperture 1806 and configured to mate withone or more corresponding recesses (not illustrated) provided on thealignment nozzle 1812 for ensuring the surgical tool 1600 is installedat a proper rotational alignment with respect to the instrument driver1800.

As illustrated, a drive interface 1816 is provided at the first end 1804a of the instrument driver 1800, and a driven interface 1818 is providedat the first end 1618 a of the drive housing 1614. The driver and driveninterfaces 1816, 1818 may be configured to mechanically, magnetically,and/or electrically couple the drive housing 1614 to the instrumentdriver 1800. To accomplish this, the driver and driven interfaces 1816,1818 may provide one or more matable locating features configured tosecure the drive housing 1614 to the instrument driver 1800. In theillustrated embodiment, for example, the drive interface 1816 providesone or more interlocking features 1820 (three shown) configured tolocate and mate with one or more substantially complimentary shapedpockets 1822 (three shown) provided on the driven interface 1818. Theinterlocking features 1820, exemplified as bulbous protrusions, may beconfigured to align and mate with the pockets 1822 via an interferenceor snap fit engagement, for example.

The instrument driver 1800 also includes one or more drive outputs thatextend through the drive interface 1816 to mate with the drive inputs1636 a-d provided on the driven face 1818 at the first end 1618 a of thedrive housing 1614. More specifically, in the illustrated embodiment,the drive interface 1816 of the instrument driver 1800 includes a firstdrive output 1824 a matable with the first drive input 1636 a, a seconddrive output 1824 b matable with the second drive input 1636 b, a thirddrive output 1824 c matable with the third drive input 1636 c, and afourth drive output 1824 d matable with the fourth drive input 1636 d.In some embodiments, as illustrated, the drive outputs 1824 a-d maycomprise splines designed to mate with corresponding splined receptacleson the drive inputs 1636 a-d. Once properly mated, the drive inputs 1636a-d will share axes of rotation with the corresponding drive outputs1824 a-d to allow the transfer of rotational torque from the driveoutputs 1824 a-d to the corresponding drive inputs 1636 a-d. In someembodiments, each drive output 1824 a-d may be spring loaded andotherwise biased to spring outwards away from the drive interface 1816.Each drive output 1824 a-d may be capable of partially or fullyretracting into the drive interface 1816.

In some embodiments, the instrument driver 1800 may include additionaldrive outputs, depicted in FIG. 18B as a fifth drive output 1824 e and asixth drive output 1824 f. The fifth and sixth drive outputs 1824 e,fmay be configured and positioned to mate with additional drive inputs(not shown) of the drive housing 1614 to help undertake one or moreadditional functions of the surgical tool. In the illustratedembodiment, the drive housing 1614 does not include additional driveinputs, and the driven interface 1818 defines corresponding pockets 1826configured to receive the fifth and sixth drive outputs 1824 e,f.

FIG. 19 illustrates the surgical tool 1600 configured with a stageportion 1902 and an instrument portion 1904 that may releasably attachto the stage portion 1902, according to one or more embodiments. In theillustrated embodiment, the instrument portion 1904 encompasses orcomprises various component parts of a surgical stapler (e.g., anendocutter), but, as mentioned elsewhere herein, in other embodimentsthe instrument portion 1904 may encompass or comprise component partsrelating to other types of surgical tools.

As illustrated, the stage portion 1902 may include an end cap orremovable cap 1906 that may be removed from the shroud 1640 so that theinstrument portion 1904 may be installed on or otherwise coupled to thestage portion 1902. In some embodiments, the end cap 1906 is removablyattachable to the second end 1618 b of the drive housing 1614 andremovable to allow the instrument portion 1904 to be mated with aproximal side of the stage portion 1902. Accordingly, the end cap 1906is sometimes referred to herein as the removable cap 1906. Here, theinstrument portion 1904 includes a handle assembly 1908 (alternativelyreferred to as a “handle drive assembly”) comprising the layers 1628b-e, the thrust bearing layer 1628 f, and the associated activatingmechanisms 1638 a-c constrained thereby, and the shaft 1602 extendsthrough a correspondingly sized central aperture in at least a portionof the handle assembly 1908. In this embodiment, the handle assembly1908 may be dropped onto a proximal side of the first layer 1628 a(i.e., the elevator layer) after removal of the removable cap 1906.

In the embodiments described above, the splines 1624 a-c (FIG. 16 ) andthe lead screw 1622 (FIG. 16 ) extend between the first and second ends1618 a,b. As described above, the splines 1624 a-c and the lead screw1622 extend from the first end 1618 a, where they are operativelyconnected to the drive inputs 1636 a-d of the surgical tool 1600 thatare matable with and driven by a corresponding drive output 1824 a-f(FIG. 18B) of the instrument driver 1800 (FIG. 18B), such that movement(rotation) of a given drive output 1824 a-f correspondingly moves(rotates) the associated drive input 1636 a-d, which thereby moves(rotates) the splines 1624 a-c and the lead screw 1622 associatedtherewith. Also in these embodiments, the splines 1624 a-c and the leadscrew 1622 extend and are operatively coupled to the removable cap 1906.

FIGS. 20A and 20B illustrate front and rear perspectives, respectively,of the removable cap 1906 of FIG. 19 . In particular, FIG. 20Aillustrates an interior engagement side 2002 of the removable cap 1906,according to one or more embodiments. The interior engagement side 2002is configured to receive the ends of the splines 1624 a-c (FIG. 16 ) andthe lead screw 1622 (FIG. 16 ) when the removable cap 1906 is installed,and also configured to permit uncoupling from the splines 1624 a-c andthe lead screw 1622 for removal of the removable cap 1906. Thus, theinterior engagement side 2002 may include couplings (receptacles) foreach of the splines and/or lead screws. In the illustrated embodiment,the interior engagement side 2002 includes three spline couplings 2004a, 2004 b, and 2004 c arranged to correspond with the three splines 1624a-c. However, the interior engagement side 2002 may include more or lessthan the three spline couplings 2004 a-c, for example, in embodimentshaving more or less than the three splines 1624 a-c. Thus, additionallocations 2004 d-f may be configured to receive additional splines ordrive elements. Here, hex head set screws 2005 are arranged at theadditional locations 2004 d-f as the illustrated embodiment utilizes thethree spline couplings 2004 a-c. In addition, the interior engagementside 2002 includes a stage coupling 2006 arranged to correspond with thelead screw 1622 (FIG. 16 ).

The spline couplings 2004 a-c and the stage coupling 2006 are rotatablymounted within the removable cap 1906, such that they rotate with theircorresponding spline 1624 a-c (FIG. 16 ) and lead screw 1622 (FIG. 16 )when engaged therewith by installing the removable cap 1906. Also, anyor all of the spline couplings 2004 a-c and/or stage coupling 2006 maybe keyed to the end geometry of their corresponding splines 1624 a-cand/or lead screw 1622. In some embodiments, the splines 1624 a-c eachinclude a square shaped end and each spline coupling 2004 a-c includes arecess correspondingly shaped to receive the particular end geometry ofthe corresponding spline 1624 a-c, so as to ensure that the splinecouplings 2004 a-c rotate with their associated splines 1624 a-c whileminimizing relative slippage there-between. It should be appreciated,however, that the splines 1624 a-c and the associated spline couplings2004 a-c may be keyed with other geometries (e.g., triangular,polygonal, ovoid, etc.) and that each associated spline and couplingpair may be keyed with a geometry different from one or more of theother associated spline and coupling pair, without departing from thepresent disclosure.

In the illustrated embodiment, the stage coupling 2006 is illustrated asa low friction thrust bearing keyed to a corresponding end geometry ofthe lead screw 1622 (FIG. 16 ). As illustrated, the geometry of thestage coupling 2006 is circular, and in such embodiments, the end of thelead screw 1622 may be received within the stage coupling 2006 via aninterference fit or the like. In other embodiments, however, the leadscrew 1622 may be differently connected to the stage coupling 2006. Inat least some embodiments, for example, the lead screw 1622 (FIG. 16 )may be threaded into the screw coupling 2006. As described herein,alternate mechanisms or actuators are utilized to affect lineartranslation of the carriage 1626 (FIG. 16 ) instead of the lead screw1622, such as, for example, a belt or cable drive actuator arranged tocause linear translation of the carriage 1626, and, in such embodiments,the stage coupling 2006 may be appropriately configured to integratewith said alternate mechanisms or actuators such that activation of theappropriately configured stage coupling correspondingly activates saidalternate mechanisms or actuators as described herein.

In the illustrated embodiment, the removable cap 1906 further includes aframe assembly 2008 and a ring 2010 arranged about the frame assembly2008. The frame assembly 2008 is configured to retain the splinecouplings 2004 a-c and the stage coupling 2006. In some examples,additional spline couplings (e.g., similar to the spline couplings 2004a-c) may be arranged at the additional locations 2004 d-f with anorganization that comports with a standard alignment of splines suchthat the removable cap 1906 is utilizable with the maximum number ofsplines even where the handle assembly 1908 (FIG. 19 ) riding thereonmay not be configured to receive input from one or more of the maximumnumber of splines.

The interior engagement side 2002 of the removable cap 1906 may beconfigured to mate with the shroud assembly 1700 (FIG. 17 ). In theillustrated example, the frame assembly 2008 includes a boss 2012protruding outward to define a plurality of alignment tabs 2014. Wheninstalling the removable cap 1906, the alignment tabs 2014 may be usedto ensure proper alignment by locating the alignment tabs 2014 withinthe corresponding alignment notches 1708 (FIG. 17 ) defined in theshroud 1640 (FIG. 17 ).

According to embodiments of the present disclosure, the removable cap1906 may be configured to allow manual actuation of the splines 1624 a-c(FIG. 16 ) and/or the lead screw 1622 (FIG. 16 ), independent of theinstrument driver 1800. FIG. 20B illustrates an exterior side 2020 ofthe removable cap 1906 that is configured for manually actuating thesplines 1624 a-c (FIG. 16 ) and the lead screw 1622 (FIG. 16 ). In theillustrated embodiment, a pair of manual control nuts 2022 a and 2022 bare provided for allowing manual rotation of the spline couplings 2004b-c, respectively, and a stage socket 2024 is provided for allowingmanual rotation of the stage coupling 2006. The manual control nuts 2022a,b are rotationally fixed to their corresponding spline coupling 2004b,c such that manual rotation of the manual control nuts 2022 a,bcorrespondingly rotates the associated spline coupling 2004 b-c as wellas the interconnected (mated) spline 1624 b,c (FIG. 16 ) when theremovable cap 1906 is installed. Similarly, the stage socket 2024 isrotationally fixed to the stage coupling 2006 such that the stage socket2024 and the stage coupling 2006 rotate in unison. In this manner, auser may manually rotate the lead screw 1622 (FIG. 16 ) when theremovable cap 1906 is installed by turning the stage socket 2024, forexample, with an Allen wrench. In other embodiments, alternate actuationis utilized to axially translate the carriage 1626 (FIG. 16 ) of thesurgical tool 1600 in lieu of the lead screw 1622, such as, for example,a belt or cable drive actuator, and in such embodiments, the user maymanually activate such alternate actuation when the removable cap 1906is installed by turning the stage socket 2024 as described herein.

Such manual features may prove advantageous in allowing a user tomanually manipulate the functions of the surgical tool 1600 (FIG. 16 ),such as articulating or firing the end effector 1604 (FIG. 16 ) and/oradvancing or retracting the elongate shaft 1602 (FIG. 16 ) by axiallytranslating the carriage 1626 (FIG. 16 ). This may help in manualbailout situations when power to the surgical tool 1600 may be lost orthe surgical tool 1600 is otherwise rendered inoperable.

In the illustrated example, the manual control nuts 2022 a,b and theircorresponding spline coupling 2004 b-c are associated with the spline1624 b,c, such that rotation of the manual control nuts 2022 a,b causesarticulation of the wrist 1606 (FIG. 16 ) and firing of the end effector1604 (FIG. 16 ). However, either or both of the manual control nuts 2022a,b and their corresponding spline coupling 2004 b-c may be associatedwith a different spline to manually actuate or drive the functionalityof the surgical tool 1600 associated with that different spline. Forexample, one of the manual control nuts 2022 a,b and its correspondingspline coupling 2004 b-c may be associated with the first spline 1624 ato open or close the jaws 1610,1612. Thus, the manual control nuts 2022a,b and their corresponding spline coupling 2004 b-c may be configuredto manually actuate or drive any functionality of the surgical tool1600, regardless of whether the end effector 1604 is configured as asurgical stapler or any of the other types of surgical instrumentsmentioned herein.

The removable cap 1906 may also be configured to manually actuate ordrive an additional function of the surgical tool 1600 that is notassociated with the manual control nuts 2022 a,b and their correspondingspline coupling 2004 b-c. For example, the removable cap 1906 may beconfigured to permit manual actuation of the first spline coupling 2004a (FIG. 20A) and the interconnected first spline 1624 a (FIG. 16 )received therein to thereby manually actuate or drive an additionalfunction of the surgical tool 1600. In the illustrated embodiment, thering 2010 is operatively coupled to the first spline coupling 2004 suchthat manually rotating the ring 2010 relative to the frame assembly 2008will correspondingly rotate the first spline coupling 2004. Here, thering 2010 extends about a periphery of the frame assembly 2008 and isarranged thereon so that it may rotate around the periphery relative tothe frame assembly 2008.

FIG. 21 is a partially exploded view of the removable cap 1906 of FIGS.20A-20B, according to one or more embodiments. In particular, FIG. 21illustrates the removable cap 1906 with the ring 2010 having beenremoved from the frame assembly 2008. As illustrated, the ring 2010includes an annular body 2100 having an inner surface 2102, and a ringgear 2104 is provided (defined) on the inner surface 2102. The ring gear2104 comprises a plurality of teeth 2106 and extends circumferentiallyabout all or a portion of the inner surface 2102. As shown, the ringgear 2104 protrudes radially inward from the inner surface 2102 and intoa bore 2107 of the body 2100 so as to define a ridge having a smallerdiameter as compared to the larger diameter of the inner surface 2102.

The frame assembly 2008 includes a body 2108 about which the ring 2010extends. The body 2108 is configured to permit rotation of the ring 2010about an axis A₁ of the frame assembly 2008 and relative to the body2108 when the ring 2010 is arranged thereon. In addition, the body 2108may be configured to inhibit axial translation of the ring 2010 relativeto the body 2108 when the ring 2010 is arranged thereon. Thus, the body2108 is configured to permit relative rotation of the ring 2010 whilesimultaneously inhibiting relative axial translation of the ring 2010.

In the illustrated embodiment, the body 2108 includes a channel 2110extending circumferentially around a periphery 2112 of the body 2108,and the channel 2110 is arranged to align with the ring gear 2104 of thering 2010 and may thus be sized accordingly. Also in the illustratedembodiment, the body 2108 comprises a top (or first) component 2114 aand a bottom (or second) component 2114 b that is separable from the topcomponent 2114 a. To assemble the body 2108, the top component 2114 amay be partially inserted into the bore 2107 of the ring 2010 from itstop until engaging the ring gear 2104, and the bottom component 2114 bmay be partially inserted into the ring 2010 from its bottom untilengaging the ring gear 2104 on the underside. One or more set screws2005 may then be used to couple the top and bottom components 2114 a-bwhile simultaneously capturing the ring gear 2104 between the top andbottom components 2114 a-b. In the illustrated, example, three setscrews 2005 are illustrated for assembling the body 2108 to the ring2010, but more or less may be used in other embodiments.

The spline coupling 2004 a may include a pinion gear 2116 having aplurality of teeth 2118. The pinion gear 2116 is secured to the splinecoupling 2004 a such that they rotate in unison (together). The piniongear 2116 may be rotatably mounted to the body 2108 such that the piniongear 2116 extends into the channel 2110 and is engageable by the ringgear 2104 through the channel 2110. Thus, the channel 2110 defines anannular surface 2120, and the annular surface 2120 and the ring gear2104 may be correspondingly sized and positioned such that the ring gear2104 travels within the channel 2110 without any interference betweenthe teeth 2106 of the ring gear 2104 and the channel 2110 as the ring2010 rotates about the body 2108 of the frame assembly 2008.

The pinion gear 2116 may be arranged such that the teeth 2118 extendbeyond the annular surface 2120 and into the channel 2110. In thismanner, the teeth 2106 of the ring gear 2104 may engage and mesh withthe teeth 2118 of the pinion gear 2116 when the ring 2010 is assembledon the frame assembly 2008, such that rotation may be imparted on thepinion gear 2116 by rotating the ring gear 2104 through interaction oftheir respective teeth 2106, 2118. Accordingly, rotation of the ring2010 about the axis A₁ of the frame assembly 2008 causes the ring gear2104 to similarly rotate about the axis A₁, which in turn causesrotation of the pinion gear 2116 intermeshed with the ring gear 2104 androtation of the spline coupling 2004 a extending from the pinion gear2116, such that the first spline 1624 a (FIG. 16 ) when received withinthe spline coupling 2004 a may be manually actuated (independent of theinstrument driver 1800 of FIG. 18A) by rotating the removable cap 1906.

The removable cap 1906 thus embodies mechanisms for manually actuatingthe lead screw 1622 and the splines 1624 a-c and, thereby, for manuallyactivating the various functions of the surgical tool 1600 associatedwith the lead screw 1622 and the splines 1624 a-c. Accordingly, when theremovable cap 1906 is installed on the (proximal) second end 1618 b ofthe surgical tool 1600, such that the stage coupling 2006 and the splinecouplings 2004 a-c are operationally engaged with the lead screw 1622and the splines 1624 a-c as mentioned above, the removable cap 1906embodies a proximal manual actuation mechanism. FIG. 22 illustrates theremovable cap 1906 configured as a proximal manual actuation mechanism2200 for manually activating one or more functions of the surgical tool1600, according to one or more embodiments. As illustrated, the proximalmanual actuation mechanism 2200 is provided to manually actuate thefirst spline coupling 2004 a, together with the first spline 1624 aarranged therein, via rotation of the ring 2010 such that a user mayutilize the proximal manual actuation mechanism 2200 to manuallyactivate the first activating mechanism 1638 a (FIG. 19 ) and therebymanually open or close the jaws 1610, 1612 (FIG. 19 ).

Accordingly, the proximal manual actuation mechanism 2200 may embody amanual jaw open and closure mechanism. However, in other embodiments,the proximal manual actuation mechanism 2200 may instead be provided tomanually activate any other functionality of the surgical tool 1600. Forexample, the proximal manual actuation mechanism 2200 may instead beprovided to manually actuate the stage coupling 2006 and the lead screw1622 arranged therein to manually activate the correspondingfunctionality of the surgical tool 1600 (i.e., to provide manualtranslation of the carriage nut 1634 (FIG. 16 ) and first layer 1628 aor the carriage 1626 (FIG. 16 ) when so assembled), such that theproximal manual actuation mechanism 2200 embodies a manual stagetranslation mechanism. In other examples, the proximal manual actuationmechanism 2200 may instead be provided to manually actuate the secondspline coupling 2004 b together with the second spline 1624 b arrangedtherein to manually drive the second activating mechanism 1638 b (FIG.16 ) and thereby manually articulate the wrist 1606 (FIG. 16 ), suchthat the proximal manual actuation mechanism 2200 embodies a manualwrist articulation mechanism. In even other examples, the proximalmanual actuation mechanism 2200 may instead be provided to manuallyactuate the third spline coupling 2004 c together with the third spline1624 c arranged therein to manually drive the third activating mechanism1638 c (FIG. 16 ) and thereby manually fire the end effector 1604 (FIG.16 ), such that the proximal manual actuation mechanism 2200 embodies amanual firing mechanism. Alternatively, the proximal manual actuationmechanism 2200 may be provided to manually activate two or morefunctions of the surgical tool 1600. As described below, the proximalmanual actuation mechanism 2200 may embody both the proximal manual jawopen and closure mechanism and the proximal manual stage translationmechanism, or various other combinations of two or more functionalities.

In FIG. 22 the removable cap 1906 is depicted without the bottomcomponent 2114 b, so as to more clearly depict example operation of theproximal manual actuation mechanism 2200. In particular, FIG. 22illustrates an exemplary interaction between the ring gear 2104 providedwithin the ring 2010 and the pinion gear 2116 provided on the splinecoupling 2004 a in which the first spline 1624 a is provided. Asdescribed above, the spline couplings 2004 a-c are each rotatablymounted within the frame assembly 2008 (FIG. 21 ), and the frameassembly 2008 is attachable to struts 1620 (when the removable cap 1906is installed) such that the frame assembly 2008 is constrained by thedrive housing 1614 and rotationally fixed to the ring 2010. In thismanner, the ring 2010 may be rotated about the frame 2008 while theframe 2008 remains stationary relative to the remainder of the drivehousing 1614.

To utilize the proximal manual actuation mechanism 2200, the user mayhold the surgical tool 1600 at the first end 1618 a (FIG. 16 ) or at theshroud 1640 and then manually apply a rotational force to (twist) thering 2010 of the removable cap 1906, which thereby causes the ring 2010to rotate about the frame assembly 2008 (FIG. 21 ). As mentioned, thering gear 2104 rotates with the ring 2010, the pinion gear 2116 rotateswith the first spline coupling 2004 a, and the ring gear 2014 and thepinion gear 2166 are operatively coupled together via intermeshing ofthe teeth 2106 of ring gear 2104 with the teeth 2118 of the pinion gear2116. Rotation of the ring 2010 and the ring gear 2104 provided thereondrives (rotates) the pinion gear 2116 operatively coupled thereto, androtation of the pinion gear 2116 correspondingly drives (rotates) thefirst spline coupling 2004 a provided on the pinion gear 2116 to therebydrive (rotate) the first spline 1624 a received in the first splinecoupling 2004 a. Thus, the proximal manual actuation mechanism 2200 maybe provided such that manually rotating of the ring 2010 in a firstrotational direction actuates of the first spline 1624 to thereby openthe jaws 1610, 1612 (FIG. 16 ), whereas manually rotating of the ring2010 in a second rotational direction (opposite the first rotationaldirection) actuates of the first spline 1624 to thereby close the jaws1610, 1612 (FIG. 16 ).

As mentioned, the proximal manual actuation mechanism 2200 may also beprovided to manually actuate one or more additional functions of thesurgical tool 1600. Thus, the stage coupling 2006 and/or either or bothof the spline couplings 2004 b-c may be operatively coupled to the ringgear 2104 such that rotation of the ring 2010 activates their associatedfunctionality(ies) while simultaneously opening or closing the jaws1610, 1612 (FIG. 16 ). For example, one or more of the stage coupling2006 and the spline couplings 2004 b-c may each be provided with apinion gear, similar as described with reference to the first splinecoupling 2004 a, to drive the stage coupling 2006 and/or splinecouplings 2004 b-c corresponding therewith and thereby cause activationof the associated functionality of the surgical tool 1600. However,other gearing mechanisms may be utilized to operatively couple the ringgear 2104 with any one or more of the stage coupling 2006 and/or thespline couplings 2004 b-c.

In one example embodiment, rotation of the proximal manual actuationmechanism 2200 manually opens or closes the jaws 1610, 1612 (FIG. 16 ),as described above, while simultaneously rotating the stage coupling2006, together with the lead screw 1622 received therein, to translatethe carriage nut 1634 (FIG. 16 ) and the first layer 1628 a (FIG. 16 )connected thereto, which may be beneficial for removing the instrumentportion 1904 (FIG. 19 ) of the surgical tool 1600 from the stage portion1902 (FIG. 19 ). In one such embodiment, rotation of ring 2010 in thefirst rotational direction causes simultaneous closure of the jaws 1610,1612 and proximal translation of the first layer 1628 a. In this manner,when the instrument portion 1904 is assembled on the stage portion 1902,the user may rotate the ring 2010 in the first rotational direction toproximally translate the carriage 1626 (FIG. 16 ) while simultaneouslyclosing the jaws 1610, 1612, such that the jaws 1610, 1612 may beretracted through the alignment nozzle 1812 (FIG. 19 ) provided at the(distal) first end 1618 a of the drive housing 1614 (FIG. 19 ) withoutinterference as the jaws 1610, 1612 translate proximally with thecarriage 1626. This dual functionality of the proximal manual actuationmechanism 2200 may prove helpful when removing the instrument portion1904 from the stage portion 1902.

The proximal manual actuation mechanism 2200 allows the user to open orclose the jaws 1610, 1612 (FIG. 16 ) (or manually activate one or moreother or additional functions of the surgical tool 1600) with a singlehand. Also, the proximal manual actuation mechanism 2200 may be utilizedto install (or exchange) a staple cartridge in the end effector 1604(FIG. 16 ). For example, a user may manipulate the proximal manualactuation mechanism 2200 the open or close the jaws 1610, 1612 whendetached from the instrument driver 1800 (FIG. 18 ) to remove a staplecartridge from the jaws 1610, 1612 and/or install a new staple cartridgetherein. However, the proximal manual actuation mechanism 2200 may alsobe manipulated when the surgical tool 1600 is attached to the instrumentdriver 1800.

In some embodiments, a manual actuation mechanism may be provided at thefirst (distal) end 1618 a of the drive housing 1614 (FIG. 18A). FIG. 23illustrates a distal manual actuation mechanism 2300 for manuallyactivating one or more functions of the surgical tool 1600, according toone or more embodiments. In the illustrated embodiment, the distalmanual actuation mechanism 2300 includes an enclosure or distal drivehousing 2302 coupled to the driven interface 1818 (FIG. 18B) provided atthe first end 1618 a of the drive housing 1614. Here, the distal drivehousing 2320 is ring shaped and rotatably coupled to the driveninterface 1818 such that the ring shaped distal drive housing 2320 mayrotate about and relative to the driven interface 1818 and the remainderof the drive housing 1614, similar to as described with regards to thering 2010 of FIGS. 21-22 . Also, a ring gear 2304 having a plurality ofteeth 2306 is provided along an inner periphery (or circumference) 2308of the distal drive housing 2302, such that the ring gear 2304 and theteeth 2306 thereof may rotate in unison with the distal drive housing2302.

As previously mentioned, the drive inputs 1636 a-d (FIG. 18B) areprovided on the driven face 1818 (FIG. 18B) at the first end 1618 a ofthe drive housing 1614. In the illustrated embodiment, the first driveinput 1636 a (FIG. 18B) is operatively coupled to the lead screw 1622such that rotation of the first drive input 1636 a correspondinglyrotates the lead screw 1622 to cause translation of the first layer 1628a (FIG. 16 ) and the carriage 1626 (FIG. 16 ) when assembled. The seconddrive input 1636 b (FIG. 18B) is operatively coupled to the first spline1624 a such that rotation of the second drive input 1636 bcorrespondingly rotates the first spline 1624 a operatively coupled tothe first activating mechanism 1638 a (FIG. 16 ) to thereby open andclose the jaws 1610, 1612 (FIG. 16 ). In addition, the third drive input1636 c (FIG. 18B) may be operatively coupled to the second spline 1624 bsuch that rotation of the third drive input 1636 c correspondinglyrotates the second spline 1624 b operatively coupled to the secondactivating mechanism 1638 b (FIG. 16 ) operable to thereby articulatethe end effector 1604 (FIG. 16 ) at the wrist 1606 (FIG. 16 ). Moreover,the fourth drive input 1636 d (FIG. 18B) may be operatively coupled tothe third spline 1624 c such that rotation of the fourth drive input1636 d correspondingly rotates the third spline 1624 c operativelycoupled to the third activating mechanism 1638 c (FIG. 18B) operable tothereby fire the cutting element (knife) at the end effector 1604.

A drive input shaft is provided on each of the drive inputs 1636 a-d(FIG. 18B), such rotation of each of the drive inputs 1636 a-d in turnrotates its respective drive input shaft. In FIG. 23 , a first driveinput shaft 2310 a is shown extending from the first drive input 1636 a(FIG. 18B) such that the first drive input shaft 2310 a rotates inunison with the first drive input 1636 a. A second drive input shaft2310 b also extends from the second drive input 1636 b (FIG. 18B) suchthat the second drive input shaft 2310 b rotates in unison with thesecond drive input 1636 b. Moreover, a third drive input shaft 2310 c isshown extending from its respective third drive input 1636 c (FIG. 18B)such that the third drive input shaft 2310 c rotates in unison with thethird drive input 1636 c. Similarly, a fourth drive input shaft 2310 d(occluded from view) extends from its respective fourth drive input 1636d (FIG. 18B), such that the fourth drive input shaft 2310 d rotates inunison with the fourth drive input 1636 d. The drive input shafts 2310a-d are rotatably mounted on a base plate 2312 of the driven face 1818(FIG. 18B).

A compound drive gear 2314 is provided on the first drive input shaft2310 a. The compound drive gear 2314 comprises a first drive gear 2314 aand a second drive gear 2314 b, and the first and second drive gears2314 a,b are each disposed on the first drive input shaft 2310 a suchthat they rotate together in unison with the first drive input shaft2310 a. Also, a stage coupling 2316 is provided on a distal end of thelead screw 1622 and the stage coupling 2316 includes a driven gear 2318extending therefrom, such that the driven gear 2318 rotates in unisonwith the lead screw 1622. The compound drive gear 2314 and the stagecoupling 2316 are arranged on the base plate 2312 such that the firstdrive gear 2314 a of the compound drive gear 2314 intermeshes with thedriven gear 2318 of the stage coupling 2316. Accordingly, the compounddrive gear 2314 and the stage coupling 2316 operatively couple the firstdrive input 1636 a (FIG. 18B) and the lead screw 1622, such thatrotation of the first drive input 1636 a correspondingly rotates thefirst drive gear 2314 a, which in turn drives the driven gear 2318intermeshed therewith to cause rotation of the stage coupling 2316 andthe lead screw 1622 to cause translation of the first layer 1628 a (FIG.16 ) and the carriage 1626 (FIG. 16 ) when assembled.

A compound idler gear 2320 operatively couples the ring gear 2304 withthe lead screw 1622, such that rotation of the distal drive housing 2302causes rotation of the lead screw 1622. In the illustrated embodiment,the compound idler gear 2320 comprises a first idler gear 2320 a and asecond idler gear 2320 b. The first and second idler gears 2320 a,b aresecured to an idler shaft 2322 and connected together to rotate inunison on the idler shaft 2322. The idler shaft 2322 and the compoundidler gear 2320 are arranged such that teeth of the first idler gear2320 a intermesh with the teeth 2306 of the ring gear 2304 and such thatteeth of the second idler gear 2320 b intermesh with the teeth of thesecond drive gear 2314 b of the compound drive gear 2314. As previouslymentioned, the second drive gear 2314 b rotates with the first drivegear 2314 a and the teeth of the first drive gear 2314 a intermesh withthe teeth of the driven gear 2318, which rotates with the stage coupling2316. Accordingly, rotation of the distal drive housing 2302 and thering gear 2304 fixed therein rotates the compound idler gear 2320 viainteraction between the ring gear 2304 and the first idler gear 2320 a,rotation of the compound idler gear 2320 in turn rotates the compounddrive gear 2314 via interaction between the second idler gear 2320 b andthe second drive gear 2314 b, and rotation of the compound drive gear2314 in turn rotates the stage coupling 2316 via interaction between thefirst drive gear 2314 a and the driven gear 2318, thereby rotating thelead screw 1622 and translating the first layer 1628 a within the drivehousing 1614. Thus, the distal manual actuation mechanism 2300 mayembody a distal manual stage translation mechanism utilized to manuallytranslate at least the first layer 1628 a (or the carriage 1626 whenassembled) within the drive housing 1614.

In other embodiments, however, the distal manual actuation mechanism2300 may embody a distal manual jaw open and closure mechanism formanually opening or closing the jaws 1610, 1612. For example, the distalmanual actuation mechanism 2300 may alternatively be provided tomanually actuate a first spline coupling 2324 a, together with the firstspline 1624 a that is rotationally fixed to the first spline coupling2324 a, via rotation of the distal drive housing 2302 such that a usermay utilize the distal manual actuation mechanism 2300 to manuallyactivate the first activating mechanism 1638 a (FIG. 19 ) and therebymanually open or close the jaws 1610, 1612 (FIG. 19 ). In this example,a pinion gear (not illustrated) attached to the first spline coupling2324 a may be provided to couple the ring gear 2304 and the first splinecoupling 2324 a, as described with reference to the pinion gear 2116 inFIGS. 21-22 . Alternatively, one or more idler gears (not illustrated)may be provided to operatively couple the ring gear 2304 and the firstspline coupling 2324 a as described with reference to FIG. 23 . Thus,various configurations of operatively connected gears having differentgear ratios, speeds, loads, or gear positions may be utilized withoutdeparting from the present disclosure. In some embodiments, the distalmanual actuation mechanism 2300 may embody both the distal manual stagetranslation mechanism and the distal manual jaw open and closuremechanism.

It will be appreciated that the distal manual actuation mechanism 2300may instead be operatively coupled to the second and/or third splines1624 b,c in addition to or instead of either or both of the lead screw1622 and the first spline 1624 a. For example, the distal manualactuation mechanism 2300 may instead be provided to manually actuate asecond spline coupling (occluded from view) together with the secondspline 1624 b arranged therein to manually drive the second activatingmechanism 1638 b (FIG. 16 ) and thereby manually articulate the wrist1606 (FIG. 16 ), such that the distal manual actuation mechanism 2300embodies a distal manual wrist articulation mechanism. In otherexamples, the distal manual actuation mechanism 2300 may instead beprovided to manually actuate a third spline coupling (occluded fromview) together with the third spline 1624 c arranged therein to manuallydrive the third activating mechanism 1638 c (FIG. 16 ) and therebymanually affect firing of the end effector 1604 (FIG. 16 ), such thatthe distal manual actuation mechanism 2300 embodies a distal manualfiring mechanism. Alternatively, the distal manual actuation mechanism2300 may be provided to manually activate two or more functions of thesurgical tool 1600. Accordingly, the distal manual actuation mechanism2300 may embody both the distal manual jaw open and closure mechanismand the distal manual stage translation mechanism, or various othercombinations of two or more functionalities of the surgical tool 1600 ina manner similar to the proximal manual actuation mechanism 2200 (FIGS.21-22 ).

FIG. 24 illustrates an alternate manual jaw opening and closuremechanism 2400, according to one or more embodiments. In the illustratedembodiment, the manual jaw opening and closure mechanism 2400(hereinafter, the “mechanism 2400”) includes a lever 2402 operativelycoupled to the carriage 1626 and movable to switch or change loading(i.e., input rotation) of the first activating mechanism 1638 a (FIG. 16). More specifically, the lever 2402 is movable to decouple (disengage)the first spline 1624 a (FIG. 16 ) from the first activating mechanism1638 a, such that the first spline 1624 a does not impart rotationalforce (load) on the first activating mechanism 1638 a (via theinstrument driver 1800 of FIG. 18B). The lever 2402 may further bemovable to load the first activating mechanism 1638 a with rotationforce to affect movement of the jaws 1610, 1612 (FIG. 16 ). As the lever2402 decouples (disengages) the first spline 1624 a from the firstactivating mechanism 1638 a, the lever 2402 may simultaneously couple(engage) the activating mechanism 1638 a to a new source of rotationalforce (load) for manually actuating first activating mechanism 1638 aand the jaws 1610, 1612.

In the illustrated embodiment, the carriage 1626 is provided in theshroud 1640 and the lever 2402 protrudes outward from the carriage 1626through an opening 2404 defined in the shroud 1640. Here, the opening2404 is defined in the form of a longitudinal slot that verticallyextends the entirety (or a substantial length) of the shroud 1640,between the first and second ends 1618 a,b (FIG. 16 ). In otherembodiments, however, the opening 2404 may be differently shaped and/orsized to allow the lever 2402 to protrude outward therefrom and to allowpivoting movement of the lever 2402, as described below. While the lever2402 is shown extending from the first layer 1628 a of the carriage1626, in other embodiments, the lever 2402 may be operatively coupled atthe second layer 1628 b, at the third layer 1628 c, or at the fourthlayer 1628 d, for example, in embodiments where the first activatingmechanism 1638 a is housed in the second layer 1628 b, the third layer1628 c, or at the fourth layer 1628 d. Also, while the lever 2402 isdescribed as being operable with regard to the first activatingmechanism 1638 a, in other embodiments, it may be integrated into thecarriage 1626 to affect loading of the carriage nut 1626, the secondactivating mechanism 1638 b (FIG. 16 ), and/or the third activatingmechanism 1638 c (FIG. 16 ), without departing from the scope of thedisclosure.

As illustrated, the lever 2402 may include a user engagement (tab)portion 2406 extending from an arm 2408. The arm 2408 extends radiallyoutward from the carriage 1626 through the opening 2404 and orients andsupports the user engagement portion 2406 in a mechanically advantageousposition for manipulation by a user. The user engagement portion 2406may further collapse, unfold, etc. into an extended state for furtherincreasing mechanical advantage. For example, the user engagementportion 2406 may unfold outward at a hinge, like a pocket knife, ortelescope outward to provide increased mechanical advantage. A pin mount2410 of a universal joint (obscured from view) extends from the carriage1626 and supports a first pin 2412 oriented along a first pivot(vertical) axis P₁. The universal joint is arranged within the arm 2408to retain and rotatably couple the lever 2402 to the pin mount 2410,such that the lever 2402 may rotate about the first pivot (vertical)axis P₁ as shown by arrow R. In this manner, the first pin 2412 operatesas a fulcrum, defined by the first pivot axis P₁, on which the arm 2408of the lever 2402 may pivot (rotate) laterally and sideways as shown byarrow R when a lateral force is applied to the user engagement portion2406.

The universal joint also pivotally couples the lever 2402 to thecarriage 1626 such that the lever 2402 may rotate about a second pivot(horizontal) axis P₂ (see FIGS. 25A-25C), as shown by directional arrowD. In the illustrated embodiment, the universal joint couples the lever2402 to the carriage 1626 such that the lever 2402 may be pivoteddownward about the second pivot (horizontal) axis P₂ (see FIG. 25 ), asshown by directional arrow D, and then pivoted laterally sideways aboutthe first pivot (vertical) axis P₁ normal to the second pivot axis P₂,as shown by rotational arrows R.

FIGS. 25A-25C are cut-away side views illustrating example operation ofthe mechanism 2400 of FIG. 24 , according to one or more embodiments. Inparticular, FIG. 25A illustrates the lever 2402 in a first (engaged)position where the first spline 1624 a is engaged with the firstactivating mechanism 1638 a. FIG. 25B illustrates the lever 2402 movedor pivoted in direction D into a second position where the first spline1624 a is disengaged from the first activating mechanism 1638 a andwhere a new manual drive source is engaged with the first activatingmechanism 1638 a. Lastly, FIG. 25C illustrates moving lever 2402 indirection R about the first pivot axis P₁ and thereby manually actuatingthe first activating mechanism 1638 a. Thus, the lever 2402 is movableabout two different axes P₁, P₂ relative to the carriage 1626, and thesefigures exemplify how pivoting or moving the lever 2402 about the secondpivot axis P₂ in direction D disengages (uncouples) the first activatingmechanism 1638 a from the first spline 1624 a while simultaneouslyengaging (coupling) the first activating mechanism 1638 a with a newmanual drive source. FIGS. 25A-C also depict how subsequently pivotingor moving the lever 2402 about the first pivot axis P₁, as shown bydirectional arrow R, manually actuates the first activating mechanism1638 a to affect opening or closure of the jaws 1610, 1612 (FIG. 16 ).The progressive views of FIGS. 25A-25C further illustrate how the firstactivating mechanism 1638 a is loaded via the first spline 1624 a drivenby the instrument drive 1800 (FIG. 18B) when the lever 2402 is in thefirst position (FIG. 25A), but that the lever 2402 may be moved into thesecond position (FIG. 25B) were it is utilizable to manually drive orload the first activating mechanism 1638 a (FIG. 25C).

In the illustrated embodiment, the elongated shaft 1602 may include orprovide a closure tube that is axially movable to open or close the jaws1610, 1612 (FIG. 16 ). Here, the first activating mechanism 1638 aincludes a driven gear 2502 provided about the exterior of the shaft1602 (i.e., the closure tube), a spline drive gear 2504 provided on thefirst spline 1624 a, and a pair of idler gears 2506, 2507 arrangedbetween the spline drive gear 2504 and the driven gear 2502 to transferrotary force from the first spline 1624 a to the driven gear 2502. Inthe illustrated embodiment, the first idler gear 2506 intermeshes withthe spline drive gear 2504 and is provided with a bevel gear 2506′ thatintermeshes with the second idler gear 2507, whereas the second idlergear 2507 is a pinion gear that intermeshes with both the driven gear2502 and the bevel gear 2506′ of the first idler gear 2506 to therebytransfer rotational input from the spline drive gear 2504. Also in theillustrated embodiment, the driven gear 2502 is provided as a rack gearfixed on the elongate shaft 1602 to thereby translate the elongate shaft1602 when driven by the second idler (pinion) gear 2507; however, inother examples, the driven gear 2502 may instead be provided as a wormgear fixed about the elongate shaft 1602 to thereby carry the elongateshaft 1602 with it as it axially translates when activated by rotationof the idler gear 2506 rather than via the second idler gear 2507.

Here, rotation of the second idler gear 2507 drives the driven gear 2502and the elongate shaft 1602 in an axial direction to thereby cause axialtranslation of the elongate shaft 1602. Thus, the spline drive gear 2504rotates with the first spline 1624 a to rotate (drive) the first idlergear 2506 and the bevel gear 2506′ thereof (when intermeshed therewithas described below), rotation of the bevel gear 2506′ drives (rotates)the second idler gear 2507, and rotation of the second idler gear 2507in turn drives the driven gear 2502 to thereby translate the elongateshaft 1602 with the driven gear 2502. In other embodiments, the secondidler 2507 and the bevel gear 2506′ may be absent and the driven gear2502 is provided as a worm gear fixed about the elongate shaft 1602 tothereby carry the elongate shaft 1602 with it as it axially translateswhen directly activated by rotation of the first idler gear 2506 thatintermeshes with the worm gear threading of the driven gear 2502 ratherthan via the second idler gear 2507. In even other embodiments, thedriven gear 2502 is provided as an internal gear (or an internallythreaded gear) matable with exterior gear teeth (or threads) defined onthe elongate shaft 1602 to axially translate the elongate shaft 1602upon rotation of the driven gear 2502, relative to the elongate shaft1602, where such relative rotation causes interaction between theinternal gear (or threads) and the external gear teeth (or threads) tothereby axially translate the elongate shaft 1602. Moreover, in othernon-illustrated embodiments, the spline drive gear 2504 directly engages(meshes) the driven gear 2502 such that the idler gear 2506 may beomitted in addition to omission of the second idler gear 2507.

As mentioned above, a universal joint 2508 may be provided for couplingthe lever 2402 to the carriage 1626 such that the lever 2402 may rotateabout both the first (vertical) pivot axis P₁ and the second(horizontal) pivot axis P₂. Thus, the arm 2408 of the lever 2402 is alsopivotally (or rotatably) coupled to the carriage 1626 such that thelever 2402 may rotate about the second (horizontal) pivot axis P₂. Inthe illustrated embodiment, the carriage supports a second pin 2515 ofthe universal joint 2508 oriented along the second pivot axis P₂. Asillustrated, the second pin 2512 extends through the arm 2408 of thelever 2402 to retain and rotatably couple the lever 2402 to the carriage1626. In this manner, the second pin 2512 operates as a second fulcrum,defined by the second pivot axis P₂, on which the lever 2402 pivots(rotates) in direction D.

The lever 2402 may include a finger or scoop portion 2514 and a set ofgear teeth 2516. The scoop portion 2514 is provided to move (lift) thespline drive gear 2504 out of engagement with the first idler gear 2506when the lever 2402 is moved about the second pivot axis P₂. The set ofgear teeth 2516 extends from the arm 2408 in alignment with a transverseaxis Ti, such that the set of gear teeth 2516 is not operatively coupledto the first idler gear 2506 when the lever 2402 is in the firstposition (FIG. 25A), and such that the set of gear teeth 2516 areoperatively coupled with the first idler gear 2506 when the lever 2402is in the second position (FIG. 25B). In the illustrated embodiment, amanual drive gear 2518 is provided on the first spline 1624 a. Here, themanual drive gear 2518 may rotate about independent of the first spline1624 a to operatively couple the set of gear teeth 2516 on the lever2402 to gear teeth of the first idler gear 2506 when the lever 2402 isin the second position (FIG. 25B). The manual drive gear 2518 rotatesindependent of the first spline 1624 a such that when the lever 2402 isin the first position (FIG. 25A), the manual drive gear 2518 may berotated by the first idler gear 2506 while the set of gear teeth 2516 onthe lever 2402 is positioned out of engagement (uncoupled) with themanual drive gear 2518 and within a plane defined by the second pivotaxis P₂ and the transverse axis Ti. Thus, both the spline drive gear2504 and the manual drive gear 2518 are mounted to the first spline 1624a, with the former being rotatably fixed thereon while the latter isrotatable thereon, and each engage the first idler gear 2506 when thelever 2402 when in the first position, and pulling the lever 2402 downin direction D disengages the spline drive gear 2504 from the firstidler gear 2506 while simultaneously engaging the set of gear teeth 2516(on the lever 2402) with the manual drive gear 2518. In one example, theset of gear teeth 2516 are configured as a set of one-way teeth, or as asingle tooth or pawl of a ratchet, with the manual drive gear 2518having corresponding teeth that are engaged by the set of gear teeth2516 when the lever 2402 is rotated in a first direction but are notengaged by the set of gear teeth 2516 when the lever 2402 is rotated inan opposite direction.

In some embodiments, a biasing element 2520 (e.g., a spring) is providedfor biasing the spline drive gear 2504 into engagement with the firstidler gear 2506. A second biasing element 2522 (e.g., a spring) may alsobe provided to help maintain the lever 2402 in the first position wherethe set of gear teeth 2516 is uncoupled from the first activatingmechanism 1638 a (FIG. 16 ). Here, the first and second biasing elements2520, 2522 bias the lever 2402 toward the first position (FIG. 25A),which can be considered a natural or default position. While theillustrated example includes both the first and second biasing elements2520, 2522, in other examples just one may be utilized and/or otherconfigurations of one or more biasing elements may be utilized instead.Moving the user engagement portion 2406 in the direction D (FIG. 25B) toovercome the biasing elements 2520, 2522 causes rotation of the lever2402 and pivoting movement of the scoop portion 2514 to thereby push(slide) the spline drive gear 2504 axially along the first spline 1624 a(against the biasing element 2520), as indicated by arrow D′ (FIG. 25B),to a position where the spline drive gear 2504 is no longer engaged withthe first idler gear 2506 (FIG. 25B). Moving the user engagement portion2406 in the direction D (FIG. 25B) also intermeshes the set of gearteeth 2516 on the lever 2402 with the gear teeth of the manual drivegear 2518, which in turn is intermeshed with the first idler gear 2506,whereby the first activating mechanism 1638 a (FIG. 16 ) may be actuatedby moving the lever 2402 about the first pivot axis P₁ as indicated bydirection R (FIG. 25C). Accordingly, the lever 2402 is operable todisengage the spline drive gear 2504 from the first idler gear 2506 anddrive the first activating mechanism 1638 a (FIG. 16 ) to affect manualopening or closing of the jaws 1610, 1612 (FIG. 16 ).

As discussed above, the instrument driver 1800 (FIG. 18B) is configuredto actuate each of the drive outputs 1824 a-f (FIG. 18B). For example,the instrument driver 1800 includes one or more motors (not illustrated)that cause rotation of the drive outputs 1824 a-f. The drive outputs1824 a-f may each be associated with an individual motor, or two or moreof the drive outputs 1824 a-f may be associated with the same individualmotor. However, one or more of the motors within the instrument driver1800 might not be backdrivable, meaning such motors are difficult tomanually rotate in either or both angular directions (i.e., clockwiseand counter-clockwise). Such motors are referred to herein as“non-backdrivable” motors and are incapable (or at least very difficult)of being manually manipulated to reverse a corresponding tool function.In cases where the instrument driver 1800 incorporates non-backdrivablemotor(s), it may be beneficial to provide a mechanism for decoupling thesplines 1624 a-c (FIG. 16 ) and/or the lead screw 1622 (FIG. 16 ) fromthe associated drive outputs 1824 a-f such that the user may manuallyactivate one or more functions of the surgical tool 1600 (FIG. 16 ).

For example, an unintended event may occur where the instrument driver1800 (FIG. 18B) has stalled and is unable to return the surgical tool1600 (FIG. 16 ) to a safe state (e.g., during a power outage). In such ascenario, the user must utilize the removable cap 1906 (FIG. 22 ), thedistal manual actuation mechanism 2300 (FIG. 23 ), and/or the manual jawopening and closure mechanism 2400 (FIG. 24 ) to manually actuate one ormore of the spline 1624 a-c and/or the lead screw 1622 (FIG. 16 ) and,thereby, manually activate the associated function of the surgical tool1600 as described above. Thus, a clutching mechanism may be provided toallow for manual activation of one or more functions of the surgicaltool 1600 without having to overcome the non-backdrivable motors withinthe instrument driver 1800.

FIG. 26A illustrates an example clutching mechanism 2600, according toone or more embodiments of the present disclosure. In the illustratedembodiment, the clutching mechanism 2600 includes a clutch 2602, a driveinput 2604, and a spline driver 2606. The drive input 2604 may be thesame as or similar to any of the drive inputs 1636 a-d of FIGS. 18A-18B.The spline driver 2606 is fixed on a spline 2608 such that rotation ofthe spline 2608 correspondingly rotates the spline driver 2606 in thesame angular direction. The spline 2608 may be the same as or similar tothe splines 1624 a-c of FIG. 16 . The clutch 2602 is designed toselectively couple the spline driver 2606 to the drive input 2604 suchthat the drive input 2604 is able to rotate the spline 2608 when theclutch 2602 is properly mated with the drive input 2604. As described inmore detail below, the clutch 2602 may be selectively movable axiallyalong an axis Y of the spline 2608 to couple (mate) and uncouple(unmate) the clutch 2602 from the drive input 2604. When the clutch 2602is uncoupled from the drive input 2604, the spline 2608 may be able torotate independent of the drive input 2604, thus allowing manual bailoutusing the spline 2608. In FIG. 26A, the clutch 2602 is depicted in afirst or “coupled” (engaged) position, where the spline 2608 isoperatively coupled to the drive input 2604 via the clutch 2602 suchthat rotation of the drive input 2604 will correspondingly rotate thespline 2608.

FIG. 26B illustrates an exploded view of the clutching mechanism 2600.In particular, FIG. 26B illustrates the spline 2608, the spline driver2606, the clutch 2602, and the drive input 2604 disassembled from eachother along the axis Y. In the illustrated embodiment, the spline driver2606 defines an opening 2610 arranged to receive a shaft 2612 of thespline 2608. Here, the opening 2610 and the shaft 2612 are keyed withcorresponding flat surfaces, such that rotation is imparted from thespline driver 2606 to the spline 2608 and vice versa. However, theopening 2610 the shaft 2612 may be differently fixed together such thatthey rotate together, without departing from the present disclosure. Forexample, a key and corresponding key way may be provided on the opening2610 and the shaft 2612.

The spline driver 2606 is configured as a pinion gear having a pluralityof external gear teeth 2614. In addition, the drive input 2604 includesa boss 2616 protruding from a flat surface 2618 of the drive input 2604,and the boss 2616 is also configured as a pinion gear having a pluralityof external gear teeth 2620. Thus, the spline driver 2606 and the boss2616 may be referred to as the spline driver pinion gear 2606 and thebossed input pinion gear 2616, respectively.

FIG. 26C illustrates a partially disassembled view of the clutchingmechanism 2600 of FIG. 26A. In particular, FIG. 26C illustrates theclutching mechanism 2600 with the clutch 2602 having been removed, so asto better illustrate the external gear teeth 2614 of the spline driver2606 and the external gear 2620 of the boss 2616 relative to each other.As shown, the external gear teeth 2614, 2620 are similar in design anddimension such that they may be driven simultaneously and in unison viaa single gear. Thus, as described below, the clutch 2602 may engage(mesh) with both the spline driver 2606 and the boss 2616simultaneously. In one non-illustrated embodiment, the clutch 2602 andthe spline driver 2606 form an integral, monolithic component that,while being rotationally fixed on the spline 2608, may translate axially(up and down) along the spline 2608, to couple (engage) and uncouple(disengage) the drive input 2604 with the spline 2608.

Returning to FIG. 26B, the clutch 2602 defines an internal gear 2622having a plurality of internal gear teeth 2624. The internal gear 2622defines an opening in the clutch 2602 within which both the boss 2616(of the drive input 2604) and the spline driver 2606 may be received. Inthis manner, the internal gear teeth 2624 of the internal gear 2622 maymesh with both the external gear teeth 2614 of the spline driver 2606and the external gear 2620 of the boss 2616.

FIG. 26D is a cross-section of the clutching mechanism 2600 andillustrates the internal gear 2622 operatively engaged with both theboss 2616 and the spline driver 2606. When the clutch 2602 is in thefirst (engaged) position, as illustrated in FIGS. 26A and 26D, both theboss 2616 and the spline driver 2606 are positioned within the openingdefined by the internal gear 2622 of the clutch 2602 and the internalgear teeth 2624 of the internal gear 2622 are engaged (meshed) with boththe external gear teeth 2614 of the spline driver 2606 and the externalgear 2620 of the boss 2616, such that torque provided by the drive input2604 may be transferred to the spline driver 2606 and the spline 2608through the clutch 2602. Accordingly, the internal gear 2622 is designedand dimensioned such that the internal gear teeth 2624 thereof aremeshable (engageable) with both sets of the external gear teeth 2614,2620 at the same time.

In addition, the internal gear 2622 of the clutch 2602 is provided suchthat it may translate axially along the axis Y, from the first (engaged)position where the drive input 2604 and the spline driver 2606 arecoupled together via the clutch 2602, to a second or “uncoupled”(disengaged) position where the clutch 2602 is no longer engaged(meshed) with the boss 2616 of the drive input 2604. When the clutch2602 is disengaged, the spline 2608 and the spline driver 2606 are ableto rotate independent of (and relative to) the drive input 2604.

In some embodiments, the clutch 2602 is biased into the first (engaged)position, such that the engaged position is the natural or default stateof the clutching mechanism 2600. Thus, a biasing element 2628 may beprovided to apply a biasing force on the clutch 2602 and thereby urgethe internal gear 2622 thereof into a meshed and engaged relationshipwith both the boss 2616 and the spline driver 2606. In some examples,the biasing element 2828 is a spring, however other types of biasingdevices may be utilized. In this manner, no user intervention is neededfor the instrument driver 1800 (FIG. 18B) to drive the splines 1624 a-cand/or the lead screw 1622 (FIG. 16 ), but the user may utilize theclutching mechanism 2600 to disengage the splines 1624 a-c and/or thelead screw 1622 from the drive inputs 1636 a-d such that one or morefunctions of the surgical tool 1600 may be manually activated withouthaving to overcome any resistance that may otherwise exist due to thepresence of a non-backdrivable motor within the instrument driver 1800(FIG. 18B).

In such embodiments, however, the biasing force applied on the clutch2602 by the biasing element 2828 will need to be overcome to move theclutch 2602 into the second (disengaged) position. In the illustratedembodiment, the clutch 2602 includes a ring 2630 (FIG. 26A) extendingaround a periphery of the clutch 2602, and a bailout armature 2632 maybe used to engage the ring 2630 and thereby transition the clutch 2602along the axis Y to the second (disengaged) position. Here, the bailoutarmature 2632 is illustrated as a U-shaped or ring shaped structuresurrounding the clutch 2602 to engage the ring 2630 thereof. However,the bailout armature 2632 may be differently configured withoutdeparting from the present disclosure. For example, the bailout armature2632 may comprise a pair of parallel plates between which the ring 2630of the clutch 2602 sandwiched.

FIGS. 27A-27D illustrate example operation of the clutching mechanism2600, according to one or more embodiments. In particular, FIGS. 27A and27B illustrate isometric and cross-sectional views, respectively, of theclutching mechanism 2600 when the clutch 2602 is in the first (engaged)position, and FIGS. 27C and 27D illustrate respective isometric andcross-sectional views of the clutching mechanism 2600 when the clutch2602 is shifted into the second (disengaged) position.

In FIG. 27A, the biasing element (not shown) applies a biasing force onthe clutch 2602 to thereby urge the clutch 2602 towards the drive input2604, as shown by arrow B₁, such that the internal gear 2622 of theclutch 2602 engages (meshes with) the bossed input pinion gear 2616(FIG. 27B). Accordingly, when the clutch 2602 is shifted into positionwhere it engages both the bossed input pinion gear 2616 (of the driveinput 2604) and the spline driver 2606, the spline 2608 is engaged withone or more of the drive outputs 1824 a-f (FIG. 18B) of the instrumentdriver 1800 (FIG. 18B), such that the activating mechanisms 1638 a-c(FIG. 16 ) are actuatable by the instrument driver 1800 (FIG. 18B).However, the user may disengage the spline 2608 from the instrumentdriver 1800 (FIG. 18B) by moving or shifting the clutch 2602 into thesecond (disengaged) position as shown in FIGS. 27C and 27D. For example,the user may activate the armature 2632 (FIG. 26A) to engage the ring2630, with force sufficient to overcome the biasing force exerted by thebiasing element (not shown), and thereby translate (or lift) the clutch2602 along the axis Y in a direction opposite B₁, as shown by arrow B₂.Accordingly, when the clutch 2602 is shifted out of engagement with thebossed input pinion gear 2616, the spline 2608 is similarly disengagedfrom the instrument driver 1800 (FIG. 18B), such that the activatingmechanisms 1638 a-c (FIG. 16 ) may be manually operated, as describedabove.

With regard to FIGS. 26A-26D and FIGS. 27A-27D, the clutching mechanism2600 is illustrated and described with reference to a single drive input2604. However, the clutching mechanism 2600 may be provided on more thanone drive input 2604. For example, each of the drive inputs 1636 a-d(FIG. 18B) may be associated with an individual clutching mechanism2600. FIG. 28 illustrates a multi-clutching assembly 2800 that can beutilized to disengage two or more of the clutching mechanisms 2600,according to one or more embodiments of the present disclosure. In theillustrated embodiment, a plurality of clutching mechanisms 2600 a-e areprovided similar to the clutching mechanism 2600 described above.Accordingly, each of the clutching mechanisms 2600 a-e includes arespective clutch 2602 a-e, a respective drive input 2604 a-e, and arespective spline driver 2606 a-e arranged on a respective spline 2608a-d. Also, one or more biasing elements (not illustrated) are providedto bias and urge the clutches 2602 a-e into engagement with theirrespective drive input 2604 a-e.

In the illustrated embodiment, the multi-clutching assembly 2800 alsoincludes one or more bailout armatures (not illustrated). The one ormore bailout armatures is/are movable to shift or move the correspondingclutches 2602 a-e out of engagement with the respective drive inputs2604 a-e, such that each of the respective splines 2608 a-d is uncoupledfrom the respective drive input 2604 a-e, thus allowing manual actuationof the splines 2608 a-e. In some examples, the bailout armature is aplate positioned in engagement with each of the clutches 2602 a-e tocouple or decouple the associated drive inputs 2604 a-e. In someexamples, the one or more bailout armatures comprises an outer ringarranged at (least partially about) the first end 1618 a (FIG. 18B)having one or more inwardly extending wedge features (ledges) positionedand oriented to engage the rings 2630 (FIG. 26A) of the clutches 2602a-e upon rotation of the outer ring. A cam profile may be provided onthe inwardly extending wedge feature(s) to decouple based upon a certainamount of rotation of the outer ring and/or to stage decoupling based onincremental rotation of the outer ring such that one or more of thedrive inputs 2604 a-e are decoupled in series with as the outer ring isincrementally rotated. Accordingly, a user may activate themulti-clutching assembly 2800 to actuate the bailout armature(s) andthereby decouple the spline(s) 2608 a-e from the instrument driver 1800(FIG. 18B).

In some embodiments, rotating the multi-clutching assembly 2800 along afirst arcuate length S₁ may be configured to actuate the bailoutarmature(s) to decouple the spline(s) 2608 a-e from the instrumentdriver 1800 (FIG. 18B). In such embodiments, the surgical tool 1600(FIG. 18B) may remain coupled to the instrument driver 1800 (FIG. 18B)as the multi-clutching assembly 2800 is rotated along the first arcuatelength S₁.

In some embodiments, the multi-clutching assembly 2800 may also beincorporated into the action of decoupling the surgical tool 1600 (FIG.18B) from the instrument driver 1800 (FIG. 18B), such that actuation ofthe bailout armature may also result in decoupling of the surgical tool1600 (FIG. 18B) from the instrument driver 1800 (FIG. 18B). In theillustrated embodiment, the multi-clutching assembly 2800 may be rotatedfurther along a second arcuate length S₂ past the first arcuate lengthS₁ and thereby decouple the surgical tool 1600 (FIG. 18B) from theinstrument driver 1800 (FIG. 18B). Thus, in such embodiments, the firstarcuate length S₁ of user input on the multi-clutching assembly 2800 mayactuate the bailout armature to disengage the splines 2608 a-d from theinstrument driver 1800 (FIG. 18B), and further activation of themulti-clutching assembly 2800 via the second arcuate length S₂ of userinput decouples the surgical tool 1600 (FIG. 18B) from the instrumentdriver 1800 (FIG. 18B). As mentioned above, the bailout armature maycomprise an outer ring arranged about the first end 1618 a (FIG. 18B)and having one or more inwardly extending wedge features (ledges) withcam profiles that engage the rings 2630 (FIG. 26A) of the clutches 2602a-e upon rotation of the outer ring. In this example, rotation of theouter ring the first arcuate length S₁ causes the bailout armature toengage the clutches 2602 a-e to thereby uncouple one or more of thesplines 2608 a-d from the respective drive input 2604 a-e, and furtherrotation of the outer ring the second arcuate length S₂ may cause theinwardly extending wedge features of the outer ring to drive one or moreejection legs against the instrument driver 1800 (FIG. 18B) to therebypress the surgical tool 1600 (FIG. 18B) off of the instrument driver1800.

In some embodiments, one or more of the clutching mechanisms 2600 a-emay be designed to permanently disable one or more functions of thesurgical tool 1600 (FIG. 18B) when activated by the user. For example,the clutching mechanism 2600 (FIGS. 26A-26D) may be provided with acatch to retain the clutch 2602 (FIGS. 26A-26D) once shifted into thefirst (engaged) position. Here, by inhibiting the clutch 2602 (FIGS.26A-26D) from shifting back into engagement with the bossed input piniongear 2616 (FIGS. 26A-26D), the associated drive input 2604 (FIGS.26A-26D) remains disengaged and uncoupled from the associated spline2608 (FIGS. 26A-26D). As described above, the bailout armature 2632 maybe plate like structures or horse-shoe shaped structures. In someexamples, the bailout armature 2632 is an outer ring arranged about thefirst end 1618 a (FIG. 18B) and having one or more inwardly oriented camprofiles that engage the ring 2630, which may be contoured to follow thecamp profile, such that clockwise rotation of the outer ring drives theclutch 2602 apart from the drive input 2604 and counter-clockwiserotation of the outer ring drives the clutch 2602 into engagement withthe drive input 2604. Here, a biasing element (e.g., a compressionspring) may be provided to bias the outer ring towards an engagedposition (e.g., biased in the counter-clockwise direction). In anotherexample, a biasing element (e.g., a compression spring) may be providedfor constantly biasing the clutch 2602 toward engagement. The catch maycomprise various mechanisms arranged to retain the clutch 2602 such thatit is “not resettable.” For example, the catch may include a leaf springfeature that engages the clutch 2602 sideways, or the catch may comprisea side sprung bump/indent that slides into a correspondingdetent/indent; and such catch mechanisms may be configured to bepermanently or temporarily inhibit resetting. As used herein, the term“armature” may refer to a power generating component in an electricalsystem that carries electrical current to thereby create torque or forcethat may be imparted on one or more additional components, such as theclutch 2602, to thereby cause movement of such one or more additionalcomponents. Also or instead, the term “armature” may refer to anintermediate component of a mechanical system that, when acted on by afirst component, directly or indirectly transfer torque or force to oneor more additional components, such as the clutch 2602, to thereby causemovement in such one or more additional components.

FIG. 29 is a cross-sectional side view of the clutching mechanism 2600of FIG. 26A incorporating an example manual override feature 2900,according to one or more embodiments. In the illustrated embodiment, themanual override feature 2900 includes a manual driver 2902 having aplurality of external gear teeth 2904. Accordingly, the manual driver2902 and the external gear teeth 2904 thereof may collectively bereferred to as a “manual driver gear.” When the clutch 2602 istranslated or shifted along the axis Y towards the manual driver 2902,as shown by arrow B₂, and out of engagement with the bossed input piniongear 2616 (of the drive input 2604), the internal gear 2622 (FIG. 26B)of the clutch 2602 will engage both the external gear teeth 2614 (FIG.26B) of the spline driver 2606 and the external gear teeth 2904 of themanual driver 2902. In this manner, the clutch 2602 is movable, from thefirst position where the clutch 2602 couples the spline driver 2606 tothe drive input 2604 such that the spline 2608 is engageable by theinstrument driver 1800 (FIG. 18B), to the second position where thespline driver 2606 is decoupled from the drive input 2604 and where theclutch 2602 instead couples the spline driver 2606 to the manual driver2902 such that the spline 2608 is engageable by the manual driver 2902.Thus, the manual override feature 2900 may be directly enabled ordisabled by actuation of the clutch 2602, such that the clutch 2602 isshiftable between the first position, where the instrument driver 1800(FIG. 18B) engages and is utilizable to drive the spline 2608 asindicated by robotic rotational input arrow R₁, to the second position,where the manual driver 2902 engages and is utilizable to drive thespline 2608 as indicated by human rotational input arrow R₂. Thus, whileFIG. 29 illustrates the clutch 2602 in the first position where itcouples the spline 2608 to the drive input 2604, the clutch 2602 ismovable in direction B₂ to couple the spline 2608 to the manual driver2902.

FIG. 30 illustrates an example bailout mechanism 3000, according to oneor more alternate embodiments of the present disclosure. In theillustrated embodiment, a drive gear 3002 is provided on the thirdspline 1624 c to engage and thereby activate the third activatingmechanism 1638 c upon rotation of the third spline 1624 c. As describedabove, activation of the third activating mechanism 1638 c causes thecutting element at the end effector 1604 (FIG. 16 ) to advance orretract. As illustrated, the third activating mechanism 1638 c isarranged in and otherwise associated with the fifth layer 1628 e of thecarriage 1626, and the drive gear 3002 is rotatably mounted within thefifth layer 1628 e. In addition, the drive gear 3002 is slidinglyprovided on the third spline 1624 c such that the drive gear 3002 mayslide along the third spline 1624 c with the fifth layer 1628 e whilerotating in unison with the third spline 1624 c and relative to thefifth layer 1628 e.

The third activating mechanism 1638 c includes a drive or firing rod3004 and a pinion gear 3006 that meshes with the drive gear 3002 suchthat rotation of the drive gear 3002 rotates the pinion gear 3006. Thepinion gear 3006 may define internal threads that mesh with anexternally threaded portion 3008 of the firing rod 3004 such thatrotation of the pinion gear 3006 axially translates the firing rod 3004along the longitudinal axis A₁. The cutting element (e.g., knife) isattached at a distal end (not shown) of the firing rod 3004 and may thusbe advanced or retracted as the firing rod 3004 translates distally orproximally, respectively, upon rotation of the pinion gear 3006 via thedrive gear 3002. Accordingly, the third activating mechanism 1638 cfires the cutting element on the firing rod 3004 upon rotation of thethird spline 1624.

According to embodiments of the present disclosure, the fifth layer 1628e may be separable from the remaining layers 1628 a-d of the carriage1626. In the illustrated embodiment, the fifth layer 1628 e is theproximal-most layer of the carriage 1626 and may be separated from thedistal layers (i.e., layers 1628 a-d) of the carriage 1626 via operationof the bailout mechanism 3000, as hereinafter described. In otherembodiments, however, one or more layers may be provided on a proximalside of the fifth layer 1628 e and removing the fifth layer 1628 e willcorrespondingly remove such additional layers from the carriage 1626.

In the illustrated embodiment, the bailout mechanism 3000 includes alatch 3010 operatively coupled to the fifth layer 1628 e and a lockingfeature 3012 provided on one or more of the layers distal to the fifthlayer 1628 e. In the illustrated embodiment, the locking feature 3012 isprovided on the fourth layer 1628 d, but could alternatively be providedon any of the other distal layers (i.e., layers 1628 a-c) in addition toor instead of the fourth layer 1628 d. Here, the locking feature 3012 isa keeper or strike protruding radially outward from the fourth layer1628 d, and the latch 3010 includes a corresponding recess 3014dimensioned in size to receive and retain the locking feature 3012 whenthe latch 3010 is in a locked position as shown in FIG. 30 .

The latch 3010 is rotatably or pivotally mounted to the fifth layer 1628e such that it may rotate or pivot between a locked position, as shownin FIG. 30 , where the latch 3010 catches and retains (engages) thelocking feature 3012, and an unlocked position, as shown in FIG. 31 ,where the latch 3010 is disengaged from the locking feature 3012. In theillustrated embodiment, a fin 3016 is provided on the fifth layer 1628 eand, as shown, the fin 3016 laterally or radially extends from the fifthlayer 1628 e outward through a window 3018 defined in the shroud 1640.The latch 3010 is pivotally or rotatably mounted to the fin 3016 suchthat the latch 3010 is accessible from an exterior of the surgical tool1600 to move the latch 3010 between the locked and unlocked positions.As shown in FIG. 30 , a pin 3020 may couple the latch 3010 to the fin3016, whereby the pin 3020 defines an axis of rotation and hinge aboutwhich the latch 3010 is movable (pivotable) between the locked andunlocked positions. However, the latch 3010 may be differently mountedon the fifth layer 1628 e to permit pivoting of the latch 3010 betweenthe locked and unlocked positions without departing from the presentdisclosure.

FIG. 31 illustrates example operation of the bailout mechanism 3000,according to one or more alternate embodiments of the presentdisclosure. In the illustrated embodiment, the bailout mechanism 3000 isinitially provided in the locked or engaged position, as shown withphantom lines 3102, where the latch 3010 is engaged with the lockingfeature 3012 to thereby couple the fifth layer 1628 e to the remaininglayers (i.e., layers 1628 a-c) of the carriage 1626. The latch 3010 maybe pivoted or rotated out of the locked or engaged position 3102, asshown by the arrow 3104, and to the unlocked or unengaged position 3106to thereby decouple the fifth layer 1628 e from the remaining layers(i.e., layers 1628 a-c) of the carriage 1626. Once the fifth layer 1628e is detached, the latch 3010 may be manually pulled proximally (orupward) towards the second end 1618 b, as shown by arrow 3108, toseparate the fifth layer 1628 e from the remaining layers of thecarriage 1626. Pulling the latch 3010 proximally 3108 willcorrespondingly pull the firing rod 3004 and the cutting elementoperatively coupled to the distal end of the firing rod 3004 in theproximal direction 3110.

In one embodiment, the latch 3010 is able to be pulled proximally 3108up to sixty (60) millimeters, however, it may be pulled to differentlengths/distances, without departing from the present disclosure.Moreover, as the fifth layer 1628 e is pulled proximally toward thesecond end 1618 b, the drive gear 3002 slides along the third spline1624 c as the fifth layer 1628 e carries it in the proximal direction.

Accordingly, the bailout mechanism 3000 is utilizable to manuallyretract the cutting element of the end effector 1604 (FIG. 16 ) byuncoupling the associated layer (i.e., the fifth layer 1628 e) from theother distal layers (i.e., layers 1628 a-c) of the carriage 1626 andthen moving (pulling) the latch 3010 proximally towards the second end1618 b. In these embodiments, the step of uncoupling includes pivotingthe latch 3010 from a locked position into an unlocked position, and thestep of moving (or pulling) the latch 3010 proximally includesretracting the firing rod 3004 within the elongate shaft 1602 to therebypull and retract the cutting element in the proximal direction.

FIG. 32 illustrates the bailout mechanism 3000 incorporating a bailoutassist mechanism 3200, according to one or more embodiments of thepresent disclosure. The bailout mechanism 3000 and the bailout assistmechanism 3200 are utilizable in bailout scenarios where the jaws 1610,1612 (FIG. 16 ) of the end effector 1604 (FIG. 16 ) are stuck on tissueand the robotic manipulator 1800 (FIG. 18 ) is unable to retract thecutting element (not shown). In FIG. 32 , the bailout mechanism 3000 isdepicted as engaged and holding the layers 1628 a-e of the carriage 1626together. A user may trigger the bailout mechanism 3000 to decouple thefifth layer 1628 e of the carriage 1626 from the remaining layers 1628a-d, as generally described above, and then utilize the bailout assistmechanism 3200 to help move (lift) the fifth layer 1628 e away from thedistal layers 1628 a-d and thereby retract the cutting element (notshown). Thereafter, the user could manually open the jaws 1610, 1612 asdescribed herein.

In the illustrated embodiment, the bailout assist mechanism 3200includes a user engagement feature 3202. Here, the user engagementfeature 3202 is a screw feature designed to receive an Allen wrench, butthe user engagement feature 3202 may be differently configured toreceive different tools, without departing from the present disclosure.Also, the user engagement feature 3202 is accessible from outside thesurgical tool 1600, such as through the window 3018 defined in theshroud 1640, such that the Allen wrench may be inserted into and throughthe window 3018 to access the user engagement feature 3202. However, inother embodiments, the user engagement feature 3202 may extend from andprotrude through the window 3018 in the shroud 1640.

The bailout assist mechanism 3200 is provided to assist separating oneor more proximal layers from the remaining distal layers of the carriage1626. Accordingly, the bailout assist mechanism 3200 is constrained byor within the layer(s) that it is operable to separate from theremaining layers of the carriage 1626. In the illustrated embodiment,the bailout assist mechanism 3200 is provided to assist separating thefifth layer 1628 e from the other layers 1628 a-d distal to the fifthlayer 1628 e. Here, the user engagement feature 3202 is provided in apillow block 3204 provided on an upper surface 3206 of the fifth layer1628 e. In other embodiments, however, the user engagement feature 3202and its operating mechanism may be provided within the fifth layer 1628e. In the illustrated embodiment, the removable cap 1906 includes araised portion 3208 provided to accommodate the pillow block 3204 whenthe carriage 1626 is translated towards the second end 1618 b, forexample, into its proximal most position. Here, the removable cap 1906includes a window portion 3210 that aligns with the window 3018 of theshroud 1640, such that they together define a continuous window throughwhich the user engagement feature 3202 is accessible, even when thecarriage 1626 is translated into its proximal most position at thesecond end 1618 b. In this manner, the carriage 1626 may be fullytranslated proximally without interference between the pillow block 3204and the removable cap 1906 such that the pillow block 3204 does notinhibit or decrease functionality provided by translation of thecarriage 1626.

FIG. 33A-33B illustrate example operation of the bailout assistmechanism 3200 in separating one or more proximal layers of the carriage1626 from the remaining distal layers, according to one or moreembodiments of the present disclosure. The user engagement feature 3202includes or otherwise forms part of a jack (or lift or spacer) 3302having an extendible leg 3304 that is axially translatable upon rotation(actuation) of the user engagement feature 3202. In the illustratedexample, the user engagement feature 3202 is matable with an Allenwrench 3306 to activate the jack 3302 and thereby advance the extendibleleg 3304 from a fully retracted position, as shown in FIG. 33A, towardan extended position, as shown in FIG. 33B. In other examples, the userengagement feature 3202 may be activated using another type of toolbesides the Allen wrench 3306, without departing from the presentdisclosure. In other examples, the user engagement feature 3202 maycomprise a ratcheting mechanism, whereby a user applies successiveupward and downward motions (rather than rotational input) toincrementally advance the extendible leg 3304 with each such downward(or upward) motion.

With reference to FIG. 33A, the latch 3010 is in the locked or engagedposition, such that the fifth layer 1628 e is coupled to the remaininglayers 1628 a-d of the carriage 1626. Here, the jack 3302 is in anonextended (retracted) condition because the carriage 1626 layers arelocked together. Also, FIG. 33A illustrates a condition where theactivating mechanism 1638 c has advanced the drive rod 3004 distally andinto the most distal end-of-stroke position. In the event the firing rod3004 needs to be retracted to correspondingly retract the cuttingelement (not shown) operatively coupled to the distal end of the drivingrod 3304, the user may manually open the latch 3010 to unlock the fifthlayer 1628 e from the remainder of the carriage 1626, and then insertthe Allen wrench 3306 into the user engagement feature 3202 to manuallycrank the user engagement feature 3202. As the user engagement feature3202 is being actuated, the leg 3304 will extend distally to urge thefifth layer 1628 e to separate from the remainder of the carriage 1626and thereby retract the driving rod 3304 and the cutting element.

In FIG. 33B, the latch 3010 is shown after having been pivoted orrotated 3104 into an unlocked position such that the jack 3302 may beactivated to separate the fifth layer 1628 e. Here, the wrench 3306 isrotated or cranked as shown by arrow W₁, and rotating or cranking W₁ thewrench 3306 advances the extendible leg 3304 from the jack 3302, asshown by arrow W₂, to thereby separate the fifth layer 1628 e from theremaining distal layers of the carriage 1626. By separating the fifthlayer 1628 e from the distal layers 1628 a-d, the jack 3202 may push thefifth layer 1628 e proximally, towards the second end 1618 b. Thecutting element (not shown) is operatively coupled to the distal end ofthe firing rod 3004, which is operatively connected to the fifth layer1628 e. Thus, the firing rod 3004 and the cutting element move with thefifth layer 1628 e proximally towards the second end 1618 b as the jack3202 expands the extendible leg 3304 to push against distal layers(e.g., the fourth layer 1628 d). In this manner, the bailout assistmechanism 3200 may be provided for manually retracting (i.e., bailingout) the cutting element by a distance W₃, for example, sixty (60)millimeters.

FIGS. 34A and 34B illustrate a bailout mechanism 3400 for a backdrivablemotor, according to one or more additional embodiments of the presentdisclosure. In the illustrated embodiment, the bailout mechanism 3400includes a lever 3402 operatively coupled to the third spline 1624 c,which is responsible for actuating the third activating mechanism 1638 cand thereby driving the firing rod 3004 and advancing or retracting thecutting element (not shown) operatively coupled to a distal end thereof.As hereinafter described, the lever 3402 is coupled to the third spline1624 c in a manner that allows the third spline 1624 c to rotaterelative to the lever 3402 when the lever 3402 is in a non-engagedposition as depicted in FIG. 34A.

As illustrated, a drive gear 3404 is provided on and rotates with thethird spline 1624 c. The drive gear 3404 is arranged to mesh with thepinion gear 3006 of the third activating mechanism 1638 c such thatrotation of the drive gear 3404 drives the pinion gear 3006 and therebyactivates the third activating mechanism 1628 c. As mentioned above,internal threads of the pinion gear 3006 mesh with the threaded portion3008 of the firing rod 3004 such that rotation of the pinion gear 3006axially translates the firing rod 3004 along the longitudinal axis A₁.The cutting element (e.g., knife) operatively coupled to the distal endof the firing rod 3004 may thus be advanced or retracted as the firingrod 3004 translates distally or proximally, respectively, upon rotationof the pinion gear 3006 via the drive gear 3404.

The bailout mechanism 3400 may further include a manual drive gear 3406provided on a proximal end of the third spline 1624 c. The manual drivegear 3406 rotates with the third spline 1624 c and is matable with thelever 3402 such that rotation of the lever 3402 causes rotation of thethird spline 1624 c and the drive gear 3404 to thereby manually activatethe third activating mechanism 1628 c. In addition, the lever 3402provides mechanical advantage for manually actuating the third spline1624 c and manually back-driving the motor.

Also in the illustrated embodiment, a removable cover 3408 is providedon or otherwise forms part of the removable cap 1906. When assembled onthe removable cap 1906 as shown in FIG. 34A, the removable cover 3408encloses the lever 3402 to inhibit unintentional manipulation of thelever 3402. The removable cover 3408 includes a gripping location 3410engageable by the user to remove the removable cover 3408 from theremovable cap 1906. The removable cover 3408 defines an interior volume3412 within which the lever 3402 is disposed when the removable cover3408 is installed on the removable cap 1906. Also, a spacer bar or“spacer” 3414 is integrated into the removable cover 3408. The spacerbar 3414 extends radially into the interior volume 3412 of the removablecover 3408 and, when the removable cover 3408 is installed on theremovable cap 1906, the spacer bar 3414 rests under the lever 3402 toretain and support the lever 3402 in a non-engaged position, as depictedin FIG. 34A, where the lever 3402 does not engage the manual drive gear3406 of the third spline 1624 c. By removing the removable cover 3408,the spacer bar 3414 is withdrawn from underneath the lever 3402, suchthat the lever 3402 is no longer supported and retained in thenon-engaged position, and then the user may move the lever 3402 into anengaged position, as depicted with reference to FIG. 34B, where thelever 3402 does engage the manual drive gear 3406 of the third spline1624 c.

The manual drive gear 3406 is rotatable relative to (independent of) thelever 3402 when the lever 3402 is positioned in the non-engaged positionas exemplified in FIG. 34A. In some embodiments, to accommodate thisrelative movement between the manual drive gear 3406 and the lever 3402,a bore 3416 is provided in the lever 3402 for receiving the manual drivegear 3406 and the third spline 1624 c. The bore 3416 and the manualdrive gear 3406 may include corresponding keyed surfaces for couplingthe manual drive gear 3406 to the lever 3402 when the lever 3402 is inthe non-engaged position. For example, at least one gear tooth or key3418 may be provided in the bore 3416 of the lever 3402 for mating witha corresponding one or more gear tooth or keyway 3420 (FIG. 34B)provided in the manual drive gear 3406 of the third spline 1624 c whenthe lever 3402 is in the non-engaged position. As shown, the key 3418 isprovided in a proximal segment or portion of the bore 3416, such thatthe key 3418 only engages the corresponding keyway 3420 (FIG. 34B) ofthe manual drive gear 3406 after the spacer bar 3414 has been removedfrom beneath the lever 3402 upon opening of the removable cover 3408 sothat the user may axially displace the lever 3402 relative to the manualdrive gear 3406, as shown by arrow 3422, to position the key 3418 withinthe corresponding keyway 3420. In addition, the bore 3416 includes adistal portion within which the manual drive gear 3406 resides when thelever 3402 is in the non-engaged position, before opening the removablecover 3408, withdrawing the spacer bar 3414 from beneath the lever 3402and then pressing the lever 3402 in direction 3422 into the engagedposition as shown in FIG. 34B. Accordingly, the lever 3402 is axiallymovable (slidable) in direction 3422 over the manual drive gear 3406 andthe third spline 1624 c, such that the manual drive gear 3405 ispositionable between the distal portion of the bore 3416, where it isfreely rotatable, and the proximal portion of the bore 3416, where it isrotatably fixed relative to the lever 3402. In the illustrated example,a keyed joint is provided for coupling the lever 3402 to the manualdrive gear 3406 when the lever 3402 is translated distally relative tothe manual drive gear 3406 to thereby position the manual drive gear3406 within the proximal portion of bore 3416, such that rotation of thelever 3402 correspondingly rotates the manual drive gear 3406 and thethird spline 1624 c.

When the lever 3402 is positioned such that the manual drive gear 3406is in the distal portion of the bore 3416, as shown in FIG. 34A, themanual drive gear 3406 may freely rotate (e.g., with the spline 1624 c)without interfering or engaging with the key 3418 of the lever 3402.Accordingly, opening the removable cover 3408 and thereby removing thespacer bar 3414 from beneath the lever 3402 causes the lever 3402 to beunsupported and movable into engagement with the manual drive gear 3406,such that the lever 3402 may then be manually rotated to actuate thethird spline 1624 c and the activating mechanism 1638 c associatedtherewith to control firing and retraction of the cutting element (notshown). In some embodiments, the removable cover 3408 may be connectedto the removable cap 1906 at a hinge joint.

In the illustrated embodiment, the drive input 1636 d of the surgicaltool 1600 remains engaged with the drive output 1824 d of the instrumentdriver 1800. Here, the instrument driver 1800 includes a backdrivablemotor which may be overcome by rotation of the lever 3402, which mayinclude one or more extendable or foldable portions to further increasemechanical advantage to overcome the motor. Thus, in the illustratedembodiment, the third spline 1624 c and the manual drive gear 3406 neednot translate axially upon removal of the removable cover 3408 and/orpressing the lever 3402. Rather, as mentioned above, the lever 3402 ismovable relative to the third spline 1624 c and the manual drive gear3406 from a first (upper) position, where the drive input 1636 d of thesurgical tool 1600 is engaged with the drive output 1824 d of theinstrument driver 1800 and the lever 3402 of the bailout mechanism 3400is disengaged from the manual drive gear 3406, to a second (lower)position, where the drive input 1636 d of the surgical tool 1600 isremains engaged with the drive output 1824 d of the instrument driver1800 but where the lever 3402 is engaged with the manual drive gear3406, such that a user may manually actuate the activating mechanism1638 c by manipulating the lever 3402 to control movement of the cuttingelement (not shown). FIG. 34A illustrate the lever 3402 in the first(upper) position, and FIG. 34B illustrates the lever 3402 in the second(lowered) position after removing the removable cover 3408 and thespacer bar 3414. In some embodiments, the drive gear 3404 is dimensionedand sized to be larger than the pinion gear 3006 such that it remainsengaged and meshed with the pinion gear 3006 even if the manual drivegear 3406 and the third spline 1624 c experience at least some axialtranslation when the lever 3402 is pressed in direction 3422.

FIG. 34B illustrates example operation of the bailout mechanism 3400 ofFIG. 34A. In the illustrated embodiment, the removable cover 3408 may beremoved by lifting or pivoting the removable cover 3408 as shown witharrow 3424. The spacer bar 3414 is integral with the removable cover3408 and thus correspondingly moves, as shown with arrow 3426, withmovement of the removable cover 3408 during opening or removal. Thus,removal of the removable cover 3408 simultaneously withdraws the spacerbar 3414 from beneath the lever 3402, such that the lever 3402 isunsupported and may be pressed as shown by arrow 3422 into engagementwith the manual drive gear 3406. Thereafter, the user may manually turnthe lever 3402, as shown by arrow 3428, to manually turn the thirdspline 1624 c and thereby actuate the third activating mechanism 1638 cto advance or retract the cutting element.

Accordingly, FIG. 34B also illustrates an exemplary method of using thebailout mechanism 3400. The method may include removing (or opening) theremovable cover 3408, engaging the lever 3402, and then manually turningthe lever 3402 to thereby manually activate a function of the surgicaltool 1600 independent of the instrument driver 1800. Here, the action ofremoving (or opening) the removable cover 3408 causes the spacer bar3414 to be withdrawn from beneath the lever 3402, such that the lever3402 is not supported in the non-engaged position, and then engaging thelever 3402 by moving (pressing) it over the manual drive gear 3406 (asindicated by arrow 3422) until the manual drive gear 3406 is positionedwithin the proximal portion of the bore 3416, where the key 3418 of thelever 3402 engages the keyway 3420 of the manual drive gear 3406 suchthat the manual drive gear 3406 and the third spline 1624 c arerotationally locked with the lever 3402. Thereafter, the user maymanually retract or advance the cutting element (not shown) by turningthe lever 3402.

FIGS. 35A and 35B illustrate an alternate bailout mechanism 3500 for anon-backdrivable motor, according to one or more additional embodimentsof the present disclosure. In the illustrated embodiment, the bailoutmechanism 3500 includes a lever 3502. The lever 3502 is positionablebetween a disengaged (first) position, where the lever 3502 is notcoupled to the third spline 1624 c, and an engaged (second) position,where the lever 3502 is utilizable to manually actuate the thirdactivating means 1638 c as described above with reference to the bailoutmechanism 3400 of FIGS. 34A and 34B. However, whereas the bailoutmechanism 3400 of FIGS. 34A and 34B maintains engagement between thethird spline 1624 c and the instrument driver 1800 as the lever 3402thereof is moved into engagement with the manual drive gear 3406 andthen actuated to manually drive the third activating mechanism 1638 c,the bailout mechanism 3500 disengages (decouples) the third spline 1624c from the instrument driver 1800 as the lever 3502 thereof is movedinto engagement with the manual drive gear 3406 such that the lever 3502may be utilized to manually drive the third activating mechanism 1638 cand thereby drive the firing rod 3004 to advance or retract the cuttingelement (not shown) operatively coupled to a distal end thereof withouthaving to overcome the motor of the instrument driver 1800. Thus, thelever 3502 is coupled to the third spline 1624 c in a manner that allowsthe third spline 1624 c to rotate relative to the lever 3502 when thelever 3502 is in a non-engaged position, as depicted in FIG. 35A, and torotate with the lever 3402 when the lever 3402 is in the engagedposition, as depicted in FIG. 35B. Also, while FIGS. 34A and 34Billustrate the lever 3402 thereof moving in the distal direction 3422,from the disengaged (first) and into the engaged (second) position, thelever 3502 of the bailout mechanism 3500 moves proximally (in a proximaldirection), from the disengaged (first) and into the engaged (second)position.

In the illustrated embodiment, the manual drive gear 3504 is providedwithin a bore 3504 of the lever 3502. The bore 3504 includes a firstsection 3506 and a second section 3508, and the lever 3502 is movablerelative to the third spline 1624 c and the manual drive gear 3406 toposition the manual drive gear 3406 in either the first section 3506 orthe second section 3508 of the bore 3504. The manual drive gear 3406 isfree rotatable when oriented within the first section 3506 of the bore3504. One or more gear teeth 3510 are provided in the second section3508 of the bore 3504, and the one or more gear teeth 3510 are arrangedto engage the manual drive gear 3406 when the manual drive gear 3406 isoriented in the second section 3508 of the bore 3504. Thus, the lever3502 is rotationally fixed (locked) with the manual drive gear 3406, andthus the third spline 1624 c, when the manual drive gear 3406 isoriented within the second section 3508 of the bore 3504. In thismanner, the lever 3502 may be manually rotated to actuate the thirdactivating means 1638 c when the lever 3502 is shifted into the engagedposition where the manual drive gear 3406 is positioned within thesecond section 3508 of the bore 3504.

The bailout mechanism 3500 further includes a biasing element 3512 and aretention pin or retaining pin 3514. In the illustrated embodiment, thebiasing element 3512 is provided between a the lever 3402 and theremovable cap 1906, and the retaining pin 3514 is provided on theremovable cover 3408 so as to extend distally therefrom within thecavity 3412 towards the lever 3502. Here, the biasing element 3512 is acompression spring that is arranged around a proximal portion of thethird spline 1624 c and that applies a proximally directed force on thelever 3502, thereby urging the lever 3502 away from the removable cap1906. However, the biasing element 3512 may comprise other types ofdevices and/or materials instead of a compression spring and need not bearranged about the third spline 1624 c as illustrated. Also, theretaining pin 3514 includes a base portion 3516 and a tip portion 3518extending from the base portion 3516. The base portion 3516 of theretaining pin 3514 is provided on an interior surface of the removablecover 3408 such that, when the removable cover 3408 is installed on theremovable cap 1906, the base portion 3516 abuts (contacts) the lever3502 and thereby counteracts the oppositely directed spring forceapplied on the lever 3502 via the biasing element 3512. In addition, tipportion 3518 is provided on a distal surface of the base portion 3516such that, when the removable cover 3408 is installed on the removablecap 1906, the tip portion 3518 abuts (contacts) the manual driver gear3406 to thereby inhibit or limit any axial translation of the thirdspline 1624 c and thus maintain the fourth drive input 1636 d thereofengaged (coupled) with the fourth drive output 1824 d of the instrumentdriver 1800.

In the illustrated embodiment, the base portion 3516 of the retainingpin 3514 pushes the lever 3502 distally towards the removable cap 1906,thereby compressing the biasing element 3512 when the removable cover3408 is installed on the removable cap 1906. In this manner, theretaining pin 3514 holds or maintains the lever 3502 in the disengagedposition, where the manual drive gear 3406 is freely rotatable withinthe first section 3506 of the bore 3504 independent of the lever 3502,and where the lever 3502 is compressing the biasing element 3512. Uponremoval of the removable cover 3408 from the removable cap 1906, thebiasing element 3512 pushes the lever 3502 relative to the manual drivegear 3506, as shown by directional arrow 3520 in FIG. 35B, into theengaged position where the one or more gear teeth 3510 in the secondsection 3508 of the bore 3504 engage (intermesh) the manual drive gear3406.

In addition, the lever 3502 includes a ledge 3522 proximate to thesecond section 3508 of the bore 3504. The ledge 3522 at least partiallyconstrains the manual drive gear 3406 within the second section 3508 andin engagement with the one or more gear teeth 3510 after the removablecap 3408 and the retaining pin 3514 thereof have been removed to therebyallow the biasing element 3512 to shift the lever 3502 proximally intothe engaged position. As the biasing element 3512 pushes (translates)the lever 3502 in the proximal direction 3520, the ledge 3522 willeventually abut (contact) a distal face (side) of the manual drive gear3406 and, as the biasing element 3512 continues to further push(translate) the lever 3502 in the proximal direction 3520, the ledges3522 will pull the manual drive gear 3406 in the proximal direction3520. Because the third spline 1624 c is connected to the manual drivegear 3406, the third spline 1624 c will axially translate in theproximal direction 3520 with the manual drive gear 3406 as the biasingelement 3512 pushes the lever 3502 towards the engaged position and, asthe third spline 1624 c continues to axially translate in the proximaldirection 3520, the fourth drive input 1636 d thereof will disengaged(uncouple) from the fourth drive output 1824 d of the instrument driver1800. Here, the drive gear 3404 is dimensioned and sized to be largerthan the pinion gear 3006 such that it remains engaged and meshed withthe pinion gear 3006 as it moves proximally when the biasing element3512 shifts the lever 3502 into the engaged position. In this manner,the biasing element 3512 is operable to shift the lever 3502 intoengagement with the manual drive gear 3406 (i.e., the engaged position),where the lever 3502 is operable to manually actuate the thirdactivating mechanism 1638 c, and operable to decouple the thirdactivating means 1638 c from the instrument driver 1800, such that thelever 3502 may be utilized without having to overcome the motor of theinstrument driver 1800.

Accordingly, FIG. 35B also illustrates an exemplary method of using thebailout mechanism 3500. The method may include removing (or opening) theremovable cover 3408 and then manually turning the lever 3502 to therebymanually activate a function of the surgical tool 1600 independent ofthe instrument driver 1800. When the removable cover 3408 is installedon the removable cap 1906, the retaining pin 3514 abutting the lever3502 acts against the biasing force applied on the lever 3502 by thebiasing element 3512 to maintain or hold the lever 3502 in thedisengaged position, where the manual drive gear 3406 is in the firstsection 3506 of the bore 3504 and freely rotatable relative to the lever3502. Thus, the action of removing (or opening) the removable cover 3408allows the biasing element 3512 to move the lever 3502 into engagementwith the manual drive gear 3406 and decouple the third spline 1624 cfrom the motor of the instrument driver 1800. In particular, thisopening action of the removable cover 3408 causes the biasing element3512 to move (shift) the lever 3502, proximally over the manual drivegear 3406 as shown by arrow 3520, such that the manual drive gear 3406is oriented in the second section 3508 of the bore 3504 where the manualdrive gear 3406 engages (intermeshes) the one or more gear teeth 3510 ofthe lever 3502 to thereby rotationally fix the lever 3502 to the manualdrive gear 3406. Also, moving the lever 3502 into the engaged positionbrings the ledge 3522 into contact with the manual drive gear 3506, suchthat the lever 3502 may carry the manual drive gear 3406 and the thirdspline 1624 c proximally as the biasing element 3512 further moves(shifts) the lever 3502 in the proximal direction 3520, therebydecoupling the drive input 1636 d from the drive output 1824 d of theinstrument driver 1800 while maintaining meshed engagement between thedrive gear 3404 and the pinion gear 3006 while the drive gear 3404 movesproximally. Thereafter, the user may manually turn the lever 3502, asshown by arrow 3428, to manually turn the third spline 1624 c andthereby actuate the third activating mechanism 1638 c to advance orretract the cutting element (not shown).

The bailout mechanisms 3400, 3500 may be integrated within the roboticsystem's computer-based control system. Thus, the surgical tool 1600 maycommunicate data and information regarding the bailout mechanisms 3400,3500 to the robotic system's computer-based control system. In someembodiments, the bailout mechanisms 3400, 3500 may include switchedtransducers (and/or various other types of sensors and actuators) thatcould provide status indication of the bailout mechanisms 3400, 3500.For example, when the surgical tool 1600 is installed on the instrumentdriver 1800 (FIG. 18B), the controller 1400 (FIG. 14 ) may be programmedto automatically detect when the operator manually engages the bailoutmechanisms 3400, 3500 (i.e., a “bail out” scenario). In these examples,the controller 1400 may be further programmed to provide instructions tothe operator on how to perform the bailout, such as visible, onscreeninstructions and/or audible instructions, etc. In some examples, uponinstallation of the surgical tool 1600 on the instrument driver 1800,the controller 1400 may be programmed to detect whether the surgicaltool 1600 has previously been subjected to a “bail out” scenario and, ifso, provide a user indication of the same (and possibly suggestmaintenance of the surgical tool 1600) and/or control (or limit) certainfunctionality of the surgical tool 1600 that has previously been “bailedout”. Furthermore, information and data regarding operation of thebailout mechanisms 3400, 3500 may be communicated and relayed inreal-time to a help center that may provide assistance and/or verify thesteps of operating the bailout mechanisms 3400, 3500. Moreover,information and data regarding operation of the bailout mechanisms 3400,3500 may be communicated and relayed in real-time to obtain emergencymedical assistance from additional physicians and/or support staff, asmay be needed in the event the surgical tool 1600 experiences a bail outscenario.

FIG. 36 illustrates the surgical tool 1600 incorporating a userinterface 3600, according to one or more additional embodiments. Theuser interface 3600 may be operated to manually translate the elongateshaft 1602 of the surgical tool 1600. In some embodiments, the userinterface 3600 includes a fin 3602 that can be grasped and manipulatedby the user to manually translate the elongate shaft 1602. The fin 3602may be operatively coupled (either directly or indirectly) to thecarriage 1626 such that the user is able to manually advance or retractthe carriage 1626 to thereby effect a corresponding translation of theelongate shaft 1602. In the illustrated embodiment, the fin 3602 isconnected to the carriage 1626 and radially protrudes outward therefromthrough the window 3018 in the shroud 1640. Here, the fin 3602 isconnected to the fifth layer 1628 e. However, the fin 3602 may insteadbe connected to one or more other layers 1628 a-d in addition to, orinstead of, the fifth layer 1628 e.

In some embodiments, as illustrated, the fin 3602 may include anoverhanging portion 3604 (alternately referred to as a “distalextension”) positionable within the window 3018 in the shroud 1640 toextend over or cover one or more of the distal layers (i.e., the layers1628 a-d) of the carriage 1626 when the fifth layer 1628 e is releasablysecured to the distal layers (i.e., the layers 1628 a-d). Here, theoverhanging portion 3604 is positioned radially outward from and coversat least the fourth layer 1628 d of the carriage 1626 when the fifthlayer 1628 e is connected to the fourth layer 1628 d. While, theoverhanging portion 3604 is illustrated as extending distally to alocation proximate the fourth layer 1628 d, in other embodiments theoverhanging portion 3604 may extend distally to a different extent(i.e., to cover one or more of the remaining layers 1628 a-c), withoutdeparting from the present disclosure. Moreover, while the fin 3602 isillustrated as a tab protruding through the window 3018 in the shroud1640, in other embodiments the fin 3602 may be provided with differentgeometries that allow a user to grasp thereto. For example, the fin 3602may include a ring 3603 or structure that at least partially surrounds(extends around) an exterior surface of the shroud 1640.

As mentioned above, the user interface 3600 can be used to manuallyadvance or retract the elongate shaft 1602 and the end effector 1604(FIG. 16 ) in embodiments where the instrument driver 1800 (FIG. 18B) isprovided with back drivable motors. For purposes of this disclosure, aback drivable motor is a motor having sufficiently low back drivingtorque that may be overcome by a user's manually applied torque whensuch user is attempting to perform a user-driven movement, and a motor's“back drivability” may be tuned by design and selection of a gear boxpositioned between the motor and its corresponding drive output 1824a-d. In these embodiments, the lead screw 1622 (FIG. 16 ) and thecarriage nut 1634 (FIG. 16 ) may have corresponding thread pitchessuitable for transforming a translation of the carriage nut 1634 alongthe lead screw 1622 into a rotation of the lead screw 1622 as thecarriage 1626 is externally acted upon by a user. Also in theseembodiments, the corresponding thread pitches of the lead screw 1622 andthe carriage nut 1634 suitable for supporting the carriage nut 1634 andthe carriage 1626 attached thereto at a particular position within thedrive housing 1614 when the user is not applying an external load to thecarriage 1626. For example, when a user applies a distally directed loadon the fin 3602, the interaction between the threads of the carriage nut1634 and the threads of the lead screw 1622 cause the lead screw 1622 torotate and backdrive the drive output 1824 a (FIG. 18B) and associatedmotor operatively coupled to the lead screw 1622 to drive the lead screw1622. As the lead screw 1622 rotates, the carriage 1626 is able totraverse the lead screw 1622 in the distal direction.

In some embodiments, the fifth layer 1628 e may be unlocked (detached)from the distal layers 1628 a-d of the carriage 1626 and, together withthe end effector 1604 (FIG. 16 ) and the shaft 1602 operatively coupledthereto, may be removed from the drive housing 1614. In embodimentswhere the surgical tool 1600 is a surgical stapler having a staplecartridge included with the end effector 1604 (FIG. 16 ), this may proveadvantageous in allowing a user to detach the fifth layer 1628 e andremove the end effector 1604 to change the end effector or replace(replenish) the staple cartridge. As will be appreciated, staplecartridges often need to be replaced or reloaded multiple times during asurgical procedure.

However, after replacing the staple cartridge and then remounting thesurgical stapler in the drive housing 1614, the operator (e.g., asurgeon) may not be able to view (via an endoscope) where the endeffector 1604 (FIG. 16 ) is located relative to the surgical sitebecause the elongate shaft 1602 and the end effector 1604 might belocated within the cannula (or trocar). To enable viewing of the endeffector 1604, a user (e.g., a nurse or surgical assistant) may be ableto carefully advance the elongate shaft 1602 into the patient cavityuntil the end effector 1604 comes into the surgeon's field of view. Inthis manner, the fin 3602 may be utilized to manually advance or movethe elongate shaft 1602 and the end effector 1604 in a safe andefficient manner into the surgeon's field of view and/or back to a lastknown position.

Manual advancement and retraction of the shaft 1602 via the fin 3602 ofthe user interface 3600 may also provide the user with real-time tactilefeedback when reinserting the elongate shaft 1602. Such real-timetactile feedback is beneficial as the user may be able to stopadvancement of the end effector 1604 if an anatomical object (e.g., anorgan) is felt (sensed) impeding advancement or insertion. This may beespecially crucial in view of the fact that objects within the surgicalenvironment often change or reposition upon withdrawal of a surgicaltool and because robotic surgical systems may be unable to “feel” if theend effector 1604 engages an organ or tissue and instead advancesthrough and thereby damages the organ or tissue. Accordingly, the userinterface 3600 may be utilized by a user to manually advance thecarriage 1626 and manually back-drive the lead screw 1622 until the endeffector 1604 reaches the surgeon's field of view (or some other knownlocation).

It should be noted that the design and function of the user interface3600 and the associated fin 3602 are not limited to that shown in FIG.36 . Rather, the user interface 3600 may include any other design of thefin 3602 that might allow a user to grasp onto the fin 3602 and manuallyurge the carriage 1626 and the coupled shaft 1602 to move along thez-axis. In some embodiments, for example, the user interface 3600 and/orthe fin 3602 may be substantially similar to the lever 2402 of FIG. 24 .In other embodiments, the user interface 3600 and/or the fin 3602 may besubstantially similar to the latch 3010 of FIGS. 30 and 32 , withoutdeparting from the scope of the disclosure.

In some embodiments, upon removal of the surgical tool 1600, theinstrument driver 1800 (FIG. 18B), and/or the controller 1400 (FIG. 14 )of the instrument driver 1800 may be programmed to remember the lastknown position of the end effector (FIG. 16 ) and the elongate shaft1602. Upon re-introduction of the surgical tool 1600, one or both of theinstrument driver 1800 and the controller 1400 may facilitatere-positioning the end effector 1604 and the elongate shaft 1602 backinto that last known position. For example, a position recognitionsystem may be provided that remembers the last known position of the endeffector 1604 and the elongate shaft 1602 and, when the fifth layer 1628e associated therewith is removed from and then re-installed on thedistal layers 3704 (FIG. 37 ), the position recognition systemrecognizes when the same tool component has been reinstalled and willallow the user to manually translate the elongate shaft 1602 and the endeffector 1604 back into the last known position.

However, if the fifth layer 1628 e of a different surgical toolcomponent is installed on the distal layers 3704 (FIG. 37 ), theposition recognition system will recognize that a different toolcomponent has been installed and will at least partially inhibit theuser from manually translating the elongate shaft 1602 and the endeffector 1604 at least some distance. In some embodiments, the positionrecognition system will recognize if the new tool component beinginstalled on the distal layers 3704 is of the same type of componentthat was previously removed such that the new tool component may bemanually advanced to the last known position of the previously removedtool component to the extent that they are of the same type. Forexample, if a robotic stapler becomes inoperable or its supply ofstaples is exhausted during a surgical procedure, a new surgical staplermay be installed on the distal layers 3704 and then manually advanced tothe last known position. Thus, not only may the position recognitionsystem remember and recognize the last known position of the endeffector 1604 and the elongate shaft 1602, but the position recognitionsystem may also ascertain whether a particular tool being installed onthe distal layers 3704 is the same tool that was just removed therefromor a new tool and, with regard to the latter, whether the new toolincludes the same type of end effector from what was previouslyinstalled on the distal layers 3704 (i.e., the same tool type) orwhether the new tool includes a different type of end effector (i.e., adifferent tool type).

Various technologies may be utilized for recognizing whether the sametool or a new tool is being mounted on the distal layers 3704 (FIG. 37 )and/or whether the new tool is of the same or different tool type. Forexample, the distal layers 3704 may include a radio-frequencyidentification (RFID) reader device positioned to read an RFID tag ofthe fifth layer 1628 e (or its connected components) and therebyidentify the particular fifth layer and components being installed onthe distal layers 3704. In some examples, physical electrical contacts,such as “pogo pin” connectors, may be utilized.

As mentioned, the position recognition system may facilitate manualadvancement of the end effector 1604 (FIG. 16 ) and the elongate shaft1602 back to the last known position. In some embodiments, the surgicaltool 1600 may provide haptic feedback to the user when the end effector1604 and elongate shaft 1602 have been manually advanced to the lastknown position. However, other types of user feedback may be provided inaddition or instead, for example, various types of audible and/or visualfeedback. In some embodiments, the position recognition system allowsmanual advancement of the end effector 1604 and elongate shaft 1602 backinto the last known position but inhibits any further manual advancementbeyond the last known position.

FIG. 36 also illustrates the user interface 3600 configured as a bailoutmechanism, according to one or more additional embodiments. In theillustrated embodiment, a release button or pin 3606 is provided on theoverhanging portion 3604 of the fin 3602 and operable to unlock thefifth layer 1628 e from the layers 1628 a-d distal thereof. In otherexamples, such as those discussed above with reference to FIGS. 24, 30,and 32 , a lever or other type of locking mechanism may be utilized inlieu of the release pin 3606. In addition, a user engagement portion3608 may be provided on the fin 3602 and/or on the overhang portion 3604thereof. Here, the user engagement portion 3608 includes a texturedsurface that is more easily manipulated or handled by the user whenbailing out and retracting the fifth layer 1628 e and the componentsconnected thereto from the shroud 1640 after unlocking the releasablepin 3606. In FIG. 36 , the release pin 3606 is shown in an engaged orlocked position, where the release pin 3606 is engaged to thereby lockthe fifth layer 1628 e to the fourth layer 1628 d (and the underlyinglayers 1628 a-c).

FIG. 37 illustrates example operation of the user interface 3600 of FIG.36 . As shown, the release pin 3606 may be grasped by a user and pulledoutward, as shown by arrow 3702, to thereby unlock the fifth or“proximal” layer 1628 e from the underlying or “distal” layers 3704.Once the release pin 3606 is released, the fifth layer 1628 e may beseparated and removed from the distal layers 3704.

FIG. 38 illustrates an enlarged cross-sectional view of the release pin3606 provided on the overhang portion 3604 of the interface 3602. Asdepicted, the release pin 3606 is in the engaged position to secure thefifth layer 1628 e to the fourth layer 1628 d. In some embodiments, thereleasable pin 3606 may be attachable within a locking feature 3802 inone or more of the distal layers 3704 (FIG. 37 ). In the illustratedembodiment, the locking feature 3802 is provided in the fourth layer1628 d, and a user may be able to pull the release pin 3606 outward 3702to decouple (unlock) the fifth layer 1628 e from the distal layers 3704.Accordingly, FIG. 38 illustrates the release pin 3606 in the lockedposition, where it is attached to the locking feature 3802 providedwithin a proximal most layer (e.g., the fourth layer 1628 d) of the oneor more distal layers 3704 (FIG. 37 ) within which the carriage nut 1634(FIG. 16 ) is constrained.

Referring again to FIG. 37 , once the release pin 3606 is shiftedoutward 3702, the fifth layer 1628 e (alternately referred to as a“proximal” layer) may then be lifted proximally within the shroud 1640,as shown by arrow 3706, while the distal layers 3704 remain stationary.As the fifth layer 1628 e is pulled proximally 3706, the elongate shaft1602 correspondingly moves proximally, as shown by arrow 3708. Then,after removing the cap 1906 from the second end 1618 b, as shown byarrow 3710, the fifth layer 1628 e, together with the elongate shaft1602 and the end effector 1604 (FIG. 16 ) coupled thereto, may beremoved from the shroud 1640. Thereafter, the fifth layer 1628 e and thecomponents operatively connected thereto may be reinserted within theshroud 1640 and reinstalled on the distal layers 3704, for example,after replacing a staple cartridge in the end effector 1604, or a newfifth layer and connected components may be reinserted within the shroud1640 and reinstalled on the distal layers 3704.

4. Implementing Systems and Terminology

It should be noted that the terms “couple,” “coupling,” “coupled” orother variations of the word couple as used herein may indicate eitheran indirect connection or a direct connection. For example, if a firstcomponent is “coupled” to a second component, the first component may beeither indirectly connected to the second component via anothercomponent or directly connected to the second component.

The functions described herein may be stored as one or more instructionson a processor-readable or computer-readable medium. The term“computer-readable medium” refers to any available medium that can beaccessed by a computer or processor. By way of example, and notlimitation, such a medium may comprise random access memory (RAM),read-only memory (ROM), electrically erasable programmable read-onlymemory (EEPROM), flash memory, compact disc read-only memory (CD-ROM) orother optical disk storage, magnetic disk storage or other magneticstorage devices, or any other medium that can be used to store desiredprogram code in the form of instructions or data structures and that canbe accessed by a computer. It should be noted that a computer-readablemedium may be tangible and non-transitory. As used herein, the term“code” may refer to software, instructions, code or data that is/areexecutable by a computing device or processor.

The methods disclosed herein comprise one or more steps or actions forachieving the described method. The method steps and/or actions may beinterchanged with one another without departing from the scope of theclaims. In other words, unless a specific order of steps or actions isrequired for proper operation of the method that is being described, theorder and/or use of specific steps and/or actions may be modifiedwithout departing from the scope of the claims.

As used herein, the term “plurality” denotes two or more. For example, aplurality of components indicates two or more components. The term“determining” encompasses a wide variety of actions and, therefore,“determining” can include calculating, computing, processing, deriving,investigating, looking up (e.g., looking up in a table, a database oranother data structure), ascertaining and the like. Also, “determining”can include receiving (e.g., receiving information), accessing (e.g.,accessing data in a memory) and the like. Also, “determining” caninclude resolving, selecting, choosing, establishing and the like.

The phrase “based on” does not mean “based only on,” unless expresslyspecified otherwise. In other words, the phrase “based on” describesboth “based only on” and “based at least on.”

The foregoing previous description of the disclosed implementations isprovided to enable any person skilled in the art to make or use thepresent invention. Various modifications to these implementations willbe readily apparent to those skilled in the art, and the genericprinciples defined herein may be applied to other implementationswithout departing from the scope of the invention. For example, it willbe appreciated that one of ordinary skill in the art will be able toemploy a number corresponding alternative and equivalent structuraldetails, such as equivalent ways of fastening, mounting, coupling, orengaging tool components, equivalent mechanisms for producing particularactuation motions, and equivalent mechanisms for delivering electricalenergy. Thus, the present invention is not intended to be limited to theimplementations shown herein but is to be accorded the widest scopeconsistent with the principles and novel features disclosed herein.

As used herein, the terms “generally” and “substantially” are intendedto encompass structural or numeral modification which do notsignificantly affect the purpose of the element or number modified bysuch term.

To aid the Patent Office and any readers of this application and anyresulting patent in interpreting the claims appended herein, applicantsdo not intend any of the appended claims or claim elements to invoke 35U.S.C. 112(f) unless the words “means for” or “step for” are explicitlyused in the particular claim.

What is claimed is:
 1. A method of manually operating a surgical tool,comprising: arranging the surgical tool adjacent a patient, the surgicaltool including: a drive housing having opposing first and second ends; aspline extending between the first and second ends and being rotatablycoupled to a drive input at the first end; a drive gear coupled to androtatable with the spline; a carriage movably mounted to the spline andhousing an activating mechanism operatively coupled to the drive gearsuch that rotation of the spline actuates the activating mechanism; anda bailout mechanism arranged at the second end and including a leverengageable with the spline; moving the lever relative to the spline froma first position, where the spline is disengaged from the lever, to asecond position, where the spline engages the lever; and manuallyrotating the lever and thereby rotating the spline and the drive gear tomanually actuate the activating mechanism.
 2. The method of claim 1,wherein the surgical tool further includes an instrument driver arrangedat an end of a robotic arm and matable with the first end of the drivehousing, and a drive output provided by the instrument driver andmatable with the drive input, the method further comprising: rotatingthe drive output and thereby correspondingly rotating the drive input toactuate the activating mechanism; and disengaging the spline and thedrive input from the drive output when the lever is moved to the secondposition, and thereby manually actuating the activating mechanismwithout backdriving a motor corresponding to the drive output.
 3. Themethod of claim 1, wherein the surgical tool further includes aninstrument driver arranged at an end of a robotic arm and matable withthe first end of the drive housing, and a drive output provided by theinstrument driver and matable with the drive input, the method furthercomprising: rotating the drive output and thereby correspondinglyrotating the drive input to actuate the activating mechanism, whereinthe spline and the drive input remain engaged with the drive output asthe lever moves between the first and second positions; and backdrivinga motor corresponding to the drive output as the lever is manuallyrotated.
 4. The method of claim 1, wherein the surgical tool furtherincludes a manual drive gear provided at a proximal end of the splineand rotatable with the spline, the method further including: rotatingthe manual drive gear relative to the lever when the lever is in thefirst position; and rotationally engaging the manual drive gear with thelever when the lever is moved to the second position.
 5. The method ofclaim 4, wherein rotationally engaging the manual drive gear with thelever comprises mating and engaging corresponding gear teeth of themanual drive gear and the lever.
 6. The method of claim 4, wherein thebailout mechanism further includes a spacer bar removably positionedunder the manual drive gear when the lever is in the first position, themethod further comprising removing the spacer bar and thereby allowingthe lever to move to the second position and into rotational engagementwith the manual drive gear.
 7. The method of claim 6, wherein thebailout mechanism further includes a removable cover mountable to thesecond end of the drive housing, the spacer bar being attached to theremovable cover, and wherein removing the spacer bar comprises removingthe removable cover from the second end of the drive housing.
 8. Themethod of claim 4, wherein the lever includes a first bore section and asecond bore section, the method further comprising: allowing the manualdrive gear to freely rotate relative to the lever when oriented in thefirst bore section; and rotating the manual drive gear with the leverwhen oriented in the second bore section.
 9. The method of claim 8,further comprising applying a biasing force on the lever with a biasingelement and thereby urging the lever towards the second position. 10.The method of claim 9, wherein the bailout mechanism further includes aremovable cover mountable at the second end of the drive housing andhaving a retaining pin attached to the removable cover, the methodfurther comprising: engaging the retaining pin against the lever whenthe removable cover is mounted on the drive housing and therebymaintaining the lever in the first position with the manual drive gearoriented in the first bore section.
 11. The method of claim 10, furthercomprising: removing the removable cover from the second end and therebymoving the retaining pin out of engagement with the lever; pushing thelever in a direction towards the second position with the biasingelement and thereby orienting the manual drive gear within the secondbore section where the manual drive gear is rotatable with the lever.12. The method of claim 11, wherein pushing the lever in the directiontowards the second position comprises: contacting the manual drive gearagainst a ledge provided within the second bore section; and pushing thelever further in the direction towards the second position with thebiasing element and thereby pulling the spline connected to the manualdrive gear in the direction towards the second position.
 13. The methodof claim 12, wherein the surgical tool further includes an elongateshaft extending distally from the carriage and penetrating the firstend, an end effector arranged at a distal end of the elongate shaft, afiring rod operatively coupled to the activating mechanism and extendingthrough the elongate shaft, and a cutting element provided at the endeffector and operatively coupled to a distal end of the firing rod, themethod further comprising: actuating the activating mechanism byrotating the spline at the drive input and thereby rotating the drivegear to translate the firing rod; and advancing or retracting thecutting element as the firing rod translates, wherein the activatingmechanism includes an internally threaded gear arranged around athreaded portion of the firing rod, the internally threaded gear beingmeshed with the drive gear on the spline such that rotation of thespline causes axial translation of the firing rod, and the drive gear isaxially longer than the internally threaded gear such that the drivegear remains meshed with the internally threaded gear when the spline isin the first and second positions.
 14. A surgical tool, comprising: adrive housing having opposing first and second ends; a spline extendingbetween the first and second ends and being rotatably coupled to a driveinput at the first end; a drive gear mounted on and rotatable with thespline; a carriage movably mounted to the spline and housing anactivating mechanism operatively coupled to the drive gear such thatrotation of the spline actuates the activating mechanism; a manual drivegear provided on a proximal end of the spline and rotatable with thespline; and a bailout mechanism arranged at the second end andincluding: a lever arranged at the second end and engageable with themanual drive gear; and a removable cover provided on the second end ofthe drive housing to enclose the lever and having a spacer barpositionable beneath the lever to support the lever in a first position,where the manual drive gear is disengaged from the lever and freelyrotatable relative to the lever, wherein, upon removal of the spacer barfrom beneath the lever, the lever is movable to a second position, wherethe lever engages the manual driver gear such that rotation of the levercorrespondingly rotates the spline.
 15. The surgical tool of claim 14,wherein the lever includes a bore having a distal portion and a proximalportion, the lever being movable to orient the manual drive gear betweenthe distal portion of the bore, where the manual drive gear is uncoupledfrom and freely rotatable independent of the lever, and the proximalportion of the bore, where the manual drive gear is coupled to the leversuch that rotation of the lever correspondingly rotates the spline. 16.The surgical tool of claim 15, wherein the bore and the manual drivegear each include a corresponding keyed surface that are engageable witheach other to couple the manual drive gear to the lever when the leveris moved, relative to the manual drive gear and in a direction towardsfirst end, to thereby orient the manual drive gear within the proximalportion of the bore.
 17. The surgical tool of claim 14, furthercomprising: an instrument driver arranged at an end of a robotic arm andmatable with the first end of the drive housing; and a drive outputprovided by the instrument driver and matable with the drive input suchthat rotation of the drive output correspondingly rotates the driveinput and thereby actuates the activating mechanism, wherein the splineremains engaged with the drive output as the lever moves between thefirst position and the second position.
 18. A surgical tool, comprising:a drive housing having opposing first and second ends; a splineextending between the first and second ends and being rotatably coupleda drive input at the first end; a drive gear coupled to and rotatablewith the spline; a carriage movably mounted to the spline and housing anactivating mechanism operatively coupled to the drive gear such thatrotation of the spline actuates the activating mechanism; a manual drivegear provided on a proximal end of the spline and rotatable with thespline; an end cap provided at the second end with the spline extendingthrough the end cap; and a bailout mechanism arranged at the second endand including: a lever provided on the proximal end of the spline andhaving a bore within which the manual drive gear is arranged, the borecomprising a first bore section, within which the manual drive gear isfreely rotatable relative to the lever, and a second bore section,within which the manual drive gear is rotatable with the lever, whereinthe lever is movable relative to the manual drive gear between a firstposition, where the manual drive gear is oriented in first bore sectionand thus disengaged from and rotatable relative to the lever, and asecond position, where the manual drive gear is oriented in second boresection and thus engaged and rotatable with lever; a biasing elementarranged to urge the lever towards the second position; and a removablecover mountable on the end cap to enclose the lever and having aretaining pin positioned within an interior of the removable cover suchthat, when the removable cover is mounted on the end cap, the retainingpin contacts the lever to thereby maintain the lever in the firstposition with the manual drive gear oriented in the first bore section,wherein, as the removable cover is removed causing the retaining pin tomove away from the lever, the biasing element pushes the lever in adirection towards the second position to thereby orient the manual drivegear within the second bore section where the manual drive gear isrotatable with the lever.
 19. The surgical tool of claim 18, wherein thelever further comprises a ledge positioned proximate the second boresection to contact the manual drive gear when oriented within the secondbore section, such that, as the biasing element translates the lever inthe direction towards the second position with the manual drive gearoriented within the second bore section of the lever, the ledge contactsthe manual drive gear to carry the manual drive gear and, thereby, topull the spline connected to the manual drive gear, in the directiontowards the second position.
 20. The surgical tool of claim 18, furthercomprising: an instrument driver arranged at an end of a robotic arm andmatable with the first end of the drive housing; and a drive outputprovided by the instrument driver and matable with the drive input suchthat rotation of the drive output correspondingly rotates the driveinput and thereby actuates the activating mechanism, wherein the splineis engaged with the drive output when the lever is in the firstposition, and disengaged from the drive output by movement of the leverinto the second position.